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The outcome of Living Donor Liver Transplant recipients with Recent Episodes of Spontaneous Bacterial Peritonitis.

Research paper by Vinayak V Nikam, Manish M Srivastava

Indexed on: 21 Nov '20Published on: 20 Nov '20Published in: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva



Abstract

BACKGROUND Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis and is associated with a high mortality rate. Only a few reports have analyzed the impact of treated SBP that occurs in the immediate pre-operative period on outcome after a living donor liver transplantation (LDLT). The results of whether post-transplant patients are dependent on pre-transplant infections are still debatable and unclear. Therefore, this study examined the outcomes of LDLT recipients with recent episodes of SBP and LDLT recipients without prior episodes of SBP. PATIENTS The records of 62 LDLT recipients who underwent LDLT were retrospectively reviewed. Twenty-four (36%) recipients had at least 1 episode of SBP before LDLT. Although, active SBP was not present in any of the recipients at the time of LDLT. Both recipient groups were compared in terms of demographic profile, perioperative and postoperative variables and outcomes. RESULTS Higher pre-operative CTP Score [mean (SD) 11.77 (1.37) vs 10.5 (1.22), p < 0.001] and prior history of renal dysfunction (mean serum creatinine (SD) 1.715 (1.08) vs 1.02 (0.479) mg/dl, p = 0.002] were more commonly associated with the SBP group as compared to non SBP group. However, there was no statistically significant difference between the two groups in terms of the following variables: previous diabetes mellitus [3 (12.5%) vs 6 (15.8%)], pre-operative MELD score [median (IQR) 21 (10 - 37) vs 22 (9 - 39)], operative time [mean (SD)789.57 (153.49) vs 800.86 (138.69) min], total number of blood transfusion [ median (IQR)10 (2 - 19) vs 8 (1- 18)], hospital stay [ median 21 vs 20 days], re-exploration[4 (16.6%) vs 2 (5.3%)], postoperative sepsis[8 (33%) vs 5 (13%)] and 30-day mortality [3 (12.5%) vs 2 (5.3%)]. CONCLUSIONS The presence of previous episodes of pre-operative SBP in LDLT recipients does not result in adverse post-operative short-term outcomes.

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