title: Pre- and perioperative factors affecting infection after living donor liver transplantation.
abstract: OBJECTIVE
  Infectious complications, including sepsis, that often occur after liver transplantation (LT) comprise the most frequent causes of in-hospital death. This study investigated the predictors of post-transplantation infectious complications to establish a strategy with which to improve short-term outcomes after LT.
  
  
  METHODS
  We used univariate and multivariate analyses to assess pre- and perioperative risk factors for post-transplantation infectious complications in 100 consecutive patients who underwent living donor LT from February 2008 through February 2010 at our institute.
  
  
  RESULTS
  Multivariate analysis showed that low preoperative body cell mass and the absence of preoperative supplementation with branched-chain amino acids were of prognostic significance for post-transplantation sepsis. In addition, Child-Pugh classification C and massive operative blood loss were independent risk factors for post-transplantation bacteremia, and preoperative low body cell mass was an independent risk factor for in-hospital death from infection.
  
  
  CONCLUSIONS
  Pretransplantation nutritional intervention and decreases in operative blood loss would help prevent post-transplantation infectious complications from developing during living donor LT. Branched-chain amino acid supplementation before LT affects the occurrence of infectious complications.
authors.affiliation: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. kaido@kuhp.kyoto-u.ac.jp
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.forename: Kouhei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D019587:Dietary Supplements; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D007564:Japan; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000597:Amino Acids, Branched-Chain