title: Outcome, incidence, and timing of infectious complications in small bowel and multivisceral organ transplantation patients.
abstract: 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.
authors.affiliation: Department of Medicine and Medical Specialities, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy. g.guaraldi@unimo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Stefania
authors.initials: S
authors.lastname: Cocchi
authors.forename: Mauro
authors.initials: M
authors.lastname: Codeluppi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: Nicola
authors.initials: N
authors.lastname: De Ruvo
authors.forename: Michele
authors.initials: M
authors.lastname: Masetti
authors.forename: Claudia
authors.initials: C
authors.lastname: Venturelli
authors.forename: Monica
authors.initials: M
authors.lastname: Pecorari
authors.forename: Antionio Daniele
authors.initials: AD
authors.lastname: Pinna
authors.forename: Roberto
authors.initials: R
authors.lastname: Esposito
mesh_terms: 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*