Outcome, incidence, and timing of infectious complications in small bowel and multivisceral organ transplantation patients.
BACKGROUND
Infectious complications still represent a major cause of morbidity and mortality in patients with organ transplantation. In particular, small bowel or multivisceral transplantation is complicated to a greater extent than other grafts as a consequence of infectious complications including sepsis.


METHODS
This prospective study assessed outcome, incidence, and timing of infections in sequential patients undergoing small bowel or multivisceral transplantation (SB/MVTx) performed at a university transplant center between January 2001 and October 2003. Nineteen patients underwent transplantation during this period, 13 of whom (68%) undergoing isolated SB and 6 (32%) MV grafts with or without liver.


RESULTS
The median follow up was 524 days (interquartile range=252-730) with an overall 24.4 person/year of observation. Postoperative mortality rate was 0.1 death/person/year; all patients, except one who died intraoperatively, were alive 6 months postsurgery. There were 100 documented infections including: 59 bacterial (2.4 events/person/year), 35 viral (1.4 events/person/year) and 6 fungal (0.2 events/person/year). Patients developed at least one episode of bacterial infection in 94% of the cases, viral infection in 67%, and fungal infection in 28%.


CONCLUSIONS
This cohort describes the very common and complex nature of infectious complications in this challenging group of transplantation patients. Larger cohorts are needed to specifically address infection risk factors and longer term outcomes.
Guaraldi
Giovanni
G
Department of Medicine and Medical Specialities, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy. g.guaraldi@unimo.it
Cocchi
Stefania
S
Codeluppi
Mauro
M
Di Benedetto
Fabrizio
F
De Ruvo
Nicola
N
Masetti
Michele
M
Venturelli
Claudia
C
Pecorari
Monica
M
Pinna
Antionio Daniele
AD
Esposito
Roberto
R
D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology; D001803:Blood Transfusion; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D009181:Mycoses / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous / Q000009:adverse effects* / Q000401:mortality; D016896:Treatment Outcome; D014777:Virus Diseases / Q000453:epidemiology; D014781:Viscera / Q000637:transplantation*