title: Probiotic use in preventing postoperative infection in liver transplant patients.
abstract: BACKGROUND
  Although liver transplantation has been widely practised, post-operative bacterial infection is still a frequent complication which contributed to an increased risk of fatality. There were studies on preoperative use of probiotics for liver transplant patients and acquired reduction in postoperative sepsis and wound infection, but the relevant clinical experience with pre- and probiotics is still limited.
  
  
  OBJECTIVE
  This study is to assess fibre and probiotic use aimed at preventing bacterial sepsis and wound complications in patients undergoing liver transplantation.
  
  
  METHODS
  There were a total of sixty-seven adult patients scheduled for liver transplantation were included in a public teaching hospital. From January to December 2011, 34 continuous patients following liver transplantation were put on fibre + probiotics. In retrospectively, from January to December 2010, 33 continuous patients were collected as a control group and they were only received fibre post operation. The incidence of bacterial infections was compared in patients receiving either fibre and lactobacillus or fibre only. Statistical analysis was performed using SPSS 15. The t test, fisher's and chi- square test was used to compare discrete variables.
  
  
  RESULTS
  In summary, in the analysis of 67 liver transplant recipients, 8.8% group A patients developed infections compared to 30.3% group B patients. The difference between groups A and B was statistically significant in both cases. In addition, the duration of antibiotic therapy was significantly shorter in the lactobacillus-group. Wound infection was the most frequent infections and enterococci the most frequently isolated bacteria. Fibre and lactobacilli were well tolerated in most cases. The operating time, amount of intra- and post-operatively transfused units of blood, fresh frozen plasma and albumin did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Combined fibre and probiotics could lower the incidence of bacterial infections and shorten the duration of antibiotic therapy following liver transplantation in comparison to conventional nutrition. In contrast to antibiotics, it is relatively cheap and does not cause resistant strains or serious side effects.
authors.affiliation: Sir Charles Gairdner hospital, Hospital Ave, Nedlands, Australia;
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Sir Charles Gairdner hospital, Hospital Ave, Nedlands, Australia;
authors.forename: Jim
authors.initials: J
authors.lastname: Chen
authors.affiliation: Sir Charles Gairdner hospital, Hospital Ave, Nedlands, Australia;
authors.forename: Jinshan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Swan district hospital, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Chalson
authors.affiliation: Swan district hospital, Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Merigan
authors.affiliation: Sir Charles Gairdner hospital, Hospital Ave, Nedlands, Australia;
authors.forename: Andrew
authors.initials: A
authors.lastname: Mitchell
keywords: Liver transplantation; bacterial infection; probiotics