title: Increased infection risk postliver transplant without pretransplant dental treatment.
abstract: OBJECTIVE
  Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life-threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post-transplant infectious complications.
  
  
  METHODS
  Medical and dental data came from hospital records and infection data from the Finnish LT registry. The follow-up was until February 2011. Of 51 patients (LT during 2000-2006), 16 had and 35 did not have dental treatment pretransplant.
  
  
  RESULTS
  Univariate Cox regression analysis demonstrated a 2.46-fold (95% CI 1.06-5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre- and post-transplant factors, the corresponding infection risk increased, respectively, to 8.17-fold (95% CI 2.19-30.6) and 8.54-fold (95% CI 1.82-40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation.
  
  
  CONCLUSIONS
  High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.
authors.affiliation: Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Helenius-Hietala
authors.forename: F
authors.initials: F
authors.lastname: Aberg
authors.forename: J H
authors.initials: JH
authors.lastname: Meurman
authors.forename: H
authors.initials: H
authors.lastname: Isoniemi
mesh_terms: D005260:Female; D005491:Focal Infection, Dental / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology*; D012189:Retrospective Studies; D018570:Risk Assessment