Orthotopic liver transplantation: an experimental study on the prevention of infections with Gram-negative organisms.
Infection with Gram-negative bacteria is frequently the cause of death in human liver transplantation. In experimental liver transplantation in mongrel dogs we detected Gram-negative septicaemia in 73% of our first 15 cases; maximal survival was 26 days. In a second series of 27 orthotopic liver transplantations in tissue-typed littermate dogs and littermate pigs the standard surgical technique and aftercare were changed with regard to four factors: an end-to-end common bile duct anastomosis was made instead of a gallbladder to duodenum anastomosis; the continuous postoperative bacteriostatic antibiotic therapy was changed to a single 2-day course of bactericidal antibiotics; preoperative selective bowel decontamination combined with postoperative protective isolation was introduced; the dosage of azathioprine used for immunosuppression was reduced..
D000667:Ampicillin / Q000627:therapeutic use; D000818:Animals; D001424:Bacterial Infections / Q000517:prevention & control*; D001431:Bacteriological Techniques; D002701:Chloramphenicol / Q000627:therapeutic use; D004285:Dogs; D005839:Gentamicins / Q000627:therapeutic use; D006088:Gram-Negative Aerobic Bacteria; D006089:Gram-Negative Anaerobic Bacteria; D007612:Kanamycin / Q000627:therapeutic use; D016031:Liver Transplantation; D009355:Neomycin / Q000627:therapeutic use; D011183:Postoperative Complications; D018805:Sepsis / Q000517:prevention & control; D013307:Streptomycin / Q000627:therapeutic use; D013514:Surgical Procedures, Operative / Q000379:methods; D013552:Swine; D013997:Time Factors
D005839:Gentamicins; D007612:Kanamycin; D002701:Chloramphenicol; D000667:Ampicillin; D009355:Neomycin; D013307:Streptomycin