title: Perioperative synbiotic treatment to prevent infectious complications in patients after elective living donor liver transplantation: a prospective randomized study.
abstract: BACKGROUND
  Although the effect of synbiotic therapy using prebiotics and probiotics has been reported in hepatobiliary surgery, there are no reports of the effect on elective living-donor liver transplantation (LDLT).
  
  
  METHODS
  Fifty adult patients undergoing LDLT between September 2005 and June 2009 were randomized into a group receiving 2 days of preoperative and 2 weeks of postoperative synbiotic therapy (Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides [the BLO group]) and a group without synbiotic therapy (the control group). Postoperative infectious complications were recorded as well as fecal microflora before and after LDLT in each group.
  
  
  RESULTS
  Only 1 systemic infection occurred in the BLO group (4%), whereas the control group showed 6 infectious complications (24%), with 3 cases of sepsis and 3 urinary tract infections with Enterococcus spp (P = .033 vs BLO group). No other type of complication showed any difference between the groups.
  
  
  CONCLUSIONS
  Infectious complications after elective LDLT significantly decreased with the perioperative administration of synbiotic therapy.
authors.affiliation: Department of Surgery, Nagasaki University, Graduate School of Biomedical Sciences, Japan. sueguchi@net.nagasaki-u.ac.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D058616:Synbiotics; D016896:Treatment Outcome