Pre- and perioperative factors affecting infection after living donor liver transplantation

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 28; no. 11; pp. 1104 - 1108
• Main Authors: Kaido, Toshimi, M.D, Mori, Akira, M.D, Ogura, Yasuhiro, M.D, Ogawa, Kouhei, M.D, Hata, Koichiro, M.D, Yoshizawa, Atsushi, M.D, Yagi, Shintaro, M.D, Uemoto, Shinji, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2012; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Amino acids; Amino Acids, Branched-Chain - therapeutic use; Biological and medical sciences; Blood; Blood Loss, Surgical - prevention & control; Body cell mass; Branched-chain amino acids; Dietary Supplements; End Stage Liver Disease - surgery; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Hepatitis; Hospitals, University; Humans; Infection; Infection - epidemiology; Infection - etiology; Infection - mortality; Japan; Liver cirrhosis; Liver transplantation; Liver Transplantation - adverse effects; Living Donors; Male; Middle Aged; Mortality; Multivariate analysis; Nutrition; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - prevention & control; Preoperative Care; Proteins; Retrospective Studies; Risk Factors; Sepsis - epidemiology; Sepsis - etiology; Sepsis - mortality; Sepsis - prevention & control; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult; Japan; Infection; Branched-chain amino acids; Nutrition; Body cell mass; Liver transplantation; Digestive system; Living donor; Liver; Transplantation; Feeding; Branched chain; Vertebrata; Mammalia; Aminoacid
• DOI: 10.1016/j.nut.2012.02.007
• ISSN: 0899-9007

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. Conclusion 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.