title: Infectious complications in the era of MELD.
abstract: BACKGROUND
  Infections are a major cause for morbidity and mortality in liver transplant recipients. So far there has been no study systematically investigating the correlation between the MELD (Model for End-Stage Liver Disease) scoring system and complications caused by infections. The aim of the present retrospective study was to evaluate the impact of the pretransplant MELD score on incidence and mortality of pneumonia and septicemia in liver transplant recipients.
  
  
  METHODS
  The clinical courses of 201 liver transplant recipients between 12/2006 and 3/2009 were recorded and analyzed on the basis of chart review. Patients were stratified into three groups (pretransplant MELD score: group I 6-20, group II ≥ 21-30, group III ≥ 31-40) and compared in terms of incidence of infection and survival.
  
  
  RESULTS
  The mean pretransplant MELD score was 22 ± 12. There were 81 patients in group I, 65 patients in group II, and 55 patients in group III. There was no difference in incidence of infections between the MELD groups. However, septicemia-associated mortality was significantly higher in group III.
  
  
  CONCLUSIONS
  A high MELD score is not associated with higher incidence of infections but it is associated with a significantly higher mortality in the case of septicemia. Prevention of infections is of utmost importance, especially in liver transplant recipients with high MELD scores.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Juntermanns
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Manka
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Dieter Paul
authors.initials: DP
authors.lastname: Hoyer
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Gernot Maximillian
authors.initials: GM
authors.lastname: Kaiser
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Sonia
authors.initials: S
authors.lastname: Radunz
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pracht
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mathé
authors.affiliation: Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.
authors.forename: Peter-Michael
authors.initials: PM
authors.lastname: Rath
authors.affiliation: Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Steinmann
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Jürgen Walter
authors.initials: JW
authors.lastname: Treckmann
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Schulze
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D012720:Severity of Illness Index; D013407:Sulbactam / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam