Factors in association with sepsis after liver transplantation:: The Hungarian experience
Factors in association with sepsis after liver transplantation:: The Hungarian experience
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DOI：
10.1016/j.transproceed.2005.03.067
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发表时间：
2005-06-01
影响因子：
0.9
通讯作者：
Kóbori, L
中科院分区：
文献类型：
--
作者：
Nemes, B;Sárváry, E;Kóbori, L
脓毒症是原位肝移植术后患者死亡的主要原因。为了确定脓毒症的危险因素，我们分析了1995年至2004年间进行的所有199例原发性OLT。根据肝移植后是否发生脓毒症，将患者分为2组。手术时间、围手术期因素和并发症进行单变量分析。将统计学显著性因素暴露于多变量分析：考克斯回归和Hosmer-Lemeshow检验。45例（23%）患者发生脓毒症。Child-Pugh评分、术前广谱抗生素（美罗培南）预防、术中红细胞输注、淀粉输注、术后出血、肝动脉血栓形成和胆漏/坏死是脓毒症的独立危险因素。我们的结果与国际经验一致。在我们中心，大量淀粉输注和广谱抗生素的长期使用用于预防不良事件，已从方案中删除。
Sepsis is the major cause of patient death after orthotopic liver transplantation (OLT). To identify risk factors for sepsis, we analyzed all 199 primary OLTs performed between 1995 and 2004. Patients were divided into 2 groups according to whether they experienced sepsis after liver transplantation. Recipient, perioperative factors, and complications were subjected to univariate analyses. Statistically significant factors were exposed to multivariate analyses: Cox regression and Hosmer-Lemeshow test. Sepsis occurred in 45 (23%) patients. Recipient Child-Pugh score, preoperative broad spectrum antibiotic (meropenem) prophylaxis, intraoperative red blood cell transfusion, starch infusion, postoperative bleeding, hepatic artery thrombosis, and biliary leakage/necrosis were independent risk factors for sepsis. Our results agree with the international experience. A high amount of starch infusion and an extended use of broad spectrum antibiotics for prophylaxis adverse experiences in our center and have been removed from the protocol.