Factors in association with sepsis after liver transplantation: the Hungarian experience.
Sepsis is the major cause of patient death after orthotopic liver transplantation (OLT). To identify risk factors for sepsis, we analyzed all 199 primary OLTs performed between 1995 and 2004. Patients were divided into 2 groups according to whether they experienced sepsis after liver transplantation. Recipient, perioperative factors, and complications were subjected to univariate analyses. Statistically significant factors were exposed to multivariate analyses: Cox regression and Hosmer-Lemeshow test. Sepsis occurred in 45 (23%) patients. Recipient Child-Pugh score, preoperative broad spectrum antibiotic (meropenem) prophylaxis, intraoperative red blood cell transfusion, starch infusion, postoperative bleeding, hepatic artery thrombosis, and biliary leakage/necrosis were independent risk factors for sepsis. Our results agree with the international experience. A high amount of starch infusion and an extended use of broad spectrum antibiotics for prophylaxis adverse experiences in our center and have been removed from the protocol.
Nemes
B
B
Transplantation and Surgical Clinic, Semmelweis University Budapest, Baross u.23, Budapest H-1087, Hungary. nemes@trans.sote.hu
Sárváry
E
E
Sótonyi
P
P
Gerlei
Z
Z
Doros
A
A
Gálffy
Z
Z
Fehérvári
I
I
Fazakas
J
J
Járay
J
J
Kóbori
L
L
D000704:Analysis of Variance; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D006814:Hungary; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D015999:Multivariate Analysis; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis; D015996:Survival Rate