Bacterial sepsis after living donor liver transplantation: The impact of early enteral nutrition

Toru Ikegami, Ken Shirabe, Shohei Yoshiya, Tomoharu Yoshizumi, Mizuki Ninomiya, Hideaki Uchiyama, Yuji Soejima, Yoshihiko Maehara

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Bacterial sepsis is a significant problem that must be addressed after living donor liver transplantation (LDLT). Study Design: A retrospective analysis of 346 adult-to-adult LDLT patients was performed. Results: Forty-six patients (13.3%) experienced bacterial sepsis, with primary and secondary origins in 23.9% and 76.1%, respectively. Gram-negative bacteria accounted for 71.7% of the bacteria isolated. The 2-year cumulative graft survival rate in patients with bacterial sepsis was 45.7%. Patients with bacterial sepsis secondary to pneumonia (n = 12) had poorer 2-year graft survival rates (16.7%) than did those with primary or other types of secondary sepsis (p = 0.004). Multivariate analysis showed that intraoperative massive blood loss >10L (p < 0.001) and no enteral feeding started within 48 hours after transplantation (p = 0.005) were significant risk factors for bacterial sepsis. Among patients who received enteral nutrition, the incidences of bacterial sepsis in patients who received enteral nutrition within 48 hours (n = 135) or later than 48 hours (n = 57) were 5.9% and 21.0%, respectively (p = 0.002). The incidence of early graft loss was 8-fold higher in recipients with massive intraoperative blood loss without early enteral nutrition (p < 0.001). Conclusions: Early enteral nutrition was associated with significantly reduced risk of developing bacterial sepsis after LDLT.

Original languageEnglish
Pages (from-to)288-295
Number of pages8
JournalJournal of the American College of Surgeons
Volume214
Issue number3
DOIs
Publication statusPublished - Mar 1 2012

Fingerprint

Living Donors
Enteral Nutrition
Liver Transplantation
Sepsis
Graft Survival
Survival Rate
Incidence
Gram-Negative Bacteria
Pneumonia
Multivariate Analysis
Transplantation
Bacteria
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Bacterial sepsis after living donor liver transplantation : The impact of early enteral nutrition. / Ikegami, Toru; Shirabe, Ken; Yoshiya, Shohei; Yoshizumi, Tomoharu; Ninomiya, Mizuki; Uchiyama, Hideaki; Soejima, Yuji; Maehara, Yoshihiko.

In: Journal of the American College of Surgeons, Vol. 214, No. 3, 01.03.2012, p. 288-295.

Research output: Contribution to journalArticle

Ikegami, Toru ; Shirabe, Ken ; Yoshiya, Shohei ; Yoshizumi, Tomoharu ; Ninomiya, Mizuki ; Uchiyama, Hideaki ; Soejima, Yuji ; Maehara, Yoshihiko. / Bacterial sepsis after living donor liver transplantation : The impact of early enteral nutrition. In: Journal of the American College of Surgeons. 2012 ; Vol. 214, No. 3. pp. 288-295.
@article{eb9eb5fcb0ca41f0a342604fdd57d5f7,
title = "Bacterial sepsis after living donor liver transplantation: The impact of early enteral nutrition",
abstract = "Background: Bacterial sepsis is a significant problem that must be addressed after living donor liver transplantation (LDLT). Study Design: A retrospective analysis of 346 adult-to-adult LDLT patients was performed. Results: Forty-six patients (13.3{\%}) experienced bacterial sepsis, with primary and secondary origins in 23.9{\%} and 76.1{\%}, respectively. Gram-negative bacteria accounted for 71.7{\%} of the bacteria isolated. The 2-year cumulative graft survival rate in patients with bacterial sepsis was 45.7{\%}. Patients with bacterial sepsis secondary to pneumonia (n = 12) had poorer 2-year graft survival rates (16.7{\%}) than did those with primary or other types of secondary sepsis (p = 0.004). Multivariate analysis showed that intraoperative massive blood loss >10L (p < 0.001) and no enteral feeding started within 48 hours after transplantation (p = 0.005) were significant risk factors for bacterial sepsis. Among patients who received enteral nutrition, the incidences of bacterial sepsis in patients who received enteral nutrition within 48 hours (n = 135) or later than 48 hours (n = 57) were 5.9{\%} and 21.0{\%}, respectively (p = 0.002). The incidence of early graft loss was 8-fold higher in recipients with massive intraoperative blood loss without early enteral nutrition (p < 0.001). Conclusions: Early enteral nutrition was associated with significantly reduced risk of developing bacterial sepsis after LDLT.",
author = "Toru Ikegami and Ken Shirabe and Shohei Yoshiya and Tomoharu Yoshizumi and Mizuki Ninomiya and Hideaki Uchiyama and Yuji Soejima and Yoshihiko Maehara",
year = "2012",
month = "3",
day = "1",
doi = "10.1016/j.jamcollsurg.2011.12.001",
language = "English",
volume = "214",
pages = "288--295",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Bacterial sepsis after living donor liver transplantation

T2 - The impact of early enteral nutrition

AU - Ikegami, Toru

AU - Shirabe, Ken

AU - Yoshiya, Shohei

AU - Yoshizumi, Tomoharu

AU - Ninomiya, Mizuki

AU - Uchiyama, Hideaki

AU - Soejima, Yuji

AU - Maehara, Yoshihiko

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Background: Bacterial sepsis is a significant problem that must be addressed after living donor liver transplantation (LDLT). Study Design: A retrospective analysis of 346 adult-to-adult LDLT patients was performed. Results: Forty-six patients (13.3%) experienced bacterial sepsis, with primary and secondary origins in 23.9% and 76.1%, respectively. Gram-negative bacteria accounted for 71.7% of the bacteria isolated. The 2-year cumulative graft survival rate in patients with bacterial sepsis was 45.7%. Patients with bacterial sepsis secondary to pneumonia (n = 12) had poorer 2-year graft survival rates (16.7%) than did those with primary or other types of secondary sepsis (p = 0.004). Multivariate analysis showed that intraoperative massive blood loss >10L (p < 0.001) and no enteral feeding started within 48 hours after transplantation (p = 0.005) were significant risk factors for bacterial sepsis. Among patients who received enteral nutrition, the incidences of bacterial sepsis in patients who received enteral nutrition within 48 hours (n = 135) or later than 48 hours (n = 57) were 5.9% and 21.0%, respectively (p = 0.002). The incidence of early graft loss was 8-fold higher in recipients with massive intraoperative blood loss without early enteral nutrition (p < 0.001). Conclusions: Early enteral nutrition was associated with significantly reduced risk of developing bacterial sepsis after LDLT.

AB - Background: Bacterial sepsis is a significant problem that must be addressed after living donor liver transplantation (LDLT). Study Design: A retrospective analysis of 346 adult-to-adult LDLT patients was performed. Results: Forty-six patients (13.3%) experienced bacterial sepsis, with primary and secondary origins in 23.9% and 76.1%, respectively. Gram-negative bacteria accounted for 71.7% of the bacteria isolated. The 2-year cumulative graft survival rate in patients with bacterial sepsis was 45.7%. Patients with bacterial sepsis secondary to pneumonia (n = 12) had poorer 2-year graft survival rates (16.7%) than did those with primary or other types of secondary sepsis (p = 0.004). Multivariate analysis showed that intraoperative massive blood loss >10L (p < 0.001) and no enteral feeding started within 48 hours after transplantation (p = 0.005) were significant risk factors for bacterial sepsis. Among patients who received enteral nutrition, the incidences of bacterial sepsis in patients who received enteral nutrition within 48 hours (n = 135) or later than 48 hours (n = 57) were 5.9% and 21.0%, respectively (p = 0.002). The incidence of early graft loss was 8-fold higher in recipients with massive intraoperative blood loss without early enteral nutrition (p < 0.001). Conclusions: Early enteral nutrition was associated with significantly reduced risk of developing bacterial sepsis after LDLT.

UR - http://www.scopus.com/inward/record.url?scp=84857650059&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857650059&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2011.12.001

DO - 10.1016/j.jamcollsurg.2011.12.001

M3 - Article

C2 - 22244203

AN - SCOPUS:84857650059

VL - 214

SP - 288

EP - 295

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 3

ER -