Liver transplantation after an acute episode of spontaneous bacterial peritonitis.
OBJECTIVE
Spontaneous bacterial peritonitis (SBP) is a common complication of advanced cirrhosis. Thus many potential transplant recipients will experience this problem while waiting for a liver donor. The minimal amount of time with the use of appropriate antibiotics after which a potential recipient can be transplanted safely is not currently known. We examined the effect of pretransplant SBP on subsequent post-transplant outcome.


METHODS
A retrospective review of the records of 100 liver transplant recipients having an episode of spontaneous bacterial peritonitis within 30 days of their transplant was performed. The records of transplant controls without an episode of spontaneous bacterial peritonitis were reviewed to compare the outcome between the two groups in terms of sepsis during the initial 30 post-transplant days.


RESULTS
Post-transplant sepsis occurred in 8.8% of the cases and 10% of the controls (NSO). Only one episode in the study group could be ascribed to the pre-transplant episode of spontaneous bacterial peritonitis and it occurred in an IgA deficient recipient.


CONCLUSIONS
These data suggest that SBP prior to liver transplantation does not lead to an increased rate of postoperative sepsis if 4 or more days of appropriate treatment for SBP are administered prior to liver transplantation.
Van Thiel
D H
DH
Transplant Center, University of Kentucky Medical Center.
Hassanein
T
T
Gurakar
A
A
Wright
H I
HI
Caraceni
P
P
De Maria
N
N
Nadir
A
A
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D010538:Peritonitis / Q000150:complications* / Q000188:drug therapy; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis; D013997:Time Factors
D000900:Anti-Bacterial Agents