title: The impact of treated bacterial infections within one month before living donor liver transplantation in adults.
abstract: BACKGROUND
  The impact of treated preoperative bacterial infections on the outcome of living-donor liver transplantation (LDLT) is not well defined. The aim of this study was to determine the frequency of pre-transplant bacterial infections within one month before LDLT and their impact on the post-transplant morbidity and mortality.
  
  
  METHODS
  We retrospectively reviewed the records of 50 adult LDLT recipients between January 2009 and October 2011. Patients were divided into two groups based on whether they had episodes of bacterial infections within one month before LDLT.
  
  
  RESULTS
  There were 20 patients who required antimicrobial therapy for pre-transplant infections. The pre-transplant infections comprised urinary tract infections (35%), cholangitis (10%), pneumonia (10%), bacteremia (5%), spontaneous bacterial peritonitis (5%), acute sinusitis (5%), subcutaneous abscess (5%), and empirical treatment (25%). Patients with pre-transplant infections had higher Child-Pugh scores [median, 11 vs. 9.5, P<0.05] and model for end-stage liver disease scores [median, 17.5 vs. 14, P<0.05] compared with the other patients. There were no correlations between the pathogens involved in the pre-transplant infections and those involved in post-transplant infections. The incidence of post-transplant infections was higher in the pre-transplant infection group within one week after LDLT, but was almost the same within one month after LDLT. The one-year survival rates were not significantly different between the groups.
  
  
  CONCLUSIONS
  Although pre-transplant infections are associated with a high risk of postoperative bacterial infection shortly after LDLT, they did not affect the short-term outcome when they had been appropriately treated before transplantation.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Carpenter
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Kinoshita
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Adachi
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Amane
authors.initials: A
authors.lastname: Kitasato
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D002437:Cefazolin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D058625:End Stage Liver Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D002437:Cefazolin