title: Impact of the duration of posttransplant renal replacement therapy on bacterial infections in liver transplant recipients.
abstract: Whether the duration of renal replacement therapy (RRT) after liver transplantation influences the rate and types of bacterial infections is not known. In this study, 47 of 299 consecutive liver transplant recipients (16%) required posttransplant RRT. The incidence of bacterial infections was higher in the RRT group versus the non-RRT group (8.84 versus 1.38 per 1000 patient days, P < 0.001). In the RRT group, 49% of the patients (23/47) required long-term RRT (≥30 days), and 51% (24/47) required short-term RRT (<30 days). Long-term RRT (hazard ratio = 2.27, 95% confidence interval = 1.16-4.47, P = 0.017) was a significant predictor of infections. Bacteremia and intra-abdominal infections were the most common sources of infections, and Enterobacteriaceae and enterococci were the predominant pathogens in both groups. The mortality rate for patients requiring RRT was higher than the rate for patients not requiring RRT (P < 0.001), but the mortality rates of the short-term RRT group and the long-term RRT group did not significantly differ (P = 0.654). In conclusion, although both short-term RRT and long-term RRT confer a higher risk of bacterial infections, only long-term RRT is a statistically significant predictor of these infections.
authors: Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors: Hsin-Yun
authors: HY
authors: Sun
authors: Thomas V
authors: TV
authors: Cacciarelli
authors: Marilyn M
authors: MM
authors: Wagener
authors: Nina
authors: N
authors: Singh
mesh_terms: D001424:Bacterial Infections / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010414:Pennsylvania; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy / Q000009:adverse effects* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome