Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis

Tomoharu Yoshizumi, K. Shirabe, Toru Ikegami, N. Yamashita, Yohei Mano, S. Yoshiya, R. Matono, N. Harimoto, H. Uchiyama, T. Toshima, Y. Maehara

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Abstract

Background: Several studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis after living-donor liver transplantation (LDLT). Methods: Blood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650 mg/dL within 7 days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3 months after LDLT were analyzed. Results: Fifty (28.2%) recipients experienced bacterial infection within 3 months of LDLT. Eighty-four (47.5%) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15 mmHg were independent risk factors for developing bacterial infection within 3 months of LDLT (P < 0.0001 P = 0.0008, and P = 0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6%) recipients developed bacterial sepsis within 3 months. Hypogammaglobulinemia, operative time >14 h, model for end-stage liver disease score >15, and no mycophenolate mofetil use were independent risk factors for developing bacterial sepsis (P = 0.009, P = 0.001, P = 0.003, and P = 0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38-12.0, respectively. Conclusions: Hypogammaglobulinemia within 7 days of LDLT was a significant risk factor for post-transplant bacterial infection and sepsis.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalTransplant Infectious Disease
Volume16
Issue number2
DOIs
Publication statusPublished - Jan 1 2014

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Living Donors
Bacterial Infections
Agammaglobulinemia
Liver Transplantation
Sepsis
Immunoglobulin G
Mycophenolic Acid
Transplants
End Stage Liver Disease
Organ Transplantation
Statistical Factor Analysis
Immunoglobulins
Infection

All Science Journal Classification (ASJC) codes

  • Transplantation
  • Infectious Diseases

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Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis. / Yoshizumi, Tomoharu; Shirabe, K.; Ikegami, Toru; Yamashita, N.; Mano, Yohei; Yoshiya, S.; Matono, R.; Harimoto, N.; Uchiyama, H.; Toshima, T.; Maehara, Y.

In: Transplant Infectious Disease, Vol. 16, No. 2, 01.01.2014, p. 225-231.

Research output: Contribution to journalArticle

Yoshizumi, T, Shirabe, K, Ikegami, T, Yamashita, N, Mano, Y, Yoshiya, S, Matono, R, Harimoto, N, Uchiyama, H, Toshima, T & Maehara, Y 2014, 'Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis', Transplant Infectious Disease, vol. 16, no. 2, pp. 225-231. https://doi.org/10.1111/tid.12188
Yoshizumi, Tomoharu ; Shirabe, K. ; Ikegami, Toru ; Yamashita, N. ; Mano, Yohei ; Yoshiya, S. ; Matono, R. ; Harimoto, N. ; Uchiyama, H. ; Toshima, T. ; Maehara, Y. / Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis. In: Transplant Infectious Disease. 2014 ; Vol. 16, No. 2. pp. 225-231.
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abstract = "Background: Several studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis after living-donor liver transplantation (LDLT). Methods: Blood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650 mg/dL within 7 days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3 months after LDLT were analyzed. Results: Fifty (28.2{\%}) recipients experienced bacterial infection within 3 months of LDLT. Eighty-four (47.5{\%}) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15 mmHg were independent risk factors for developing bacterial infection within 3 months of LDLT (P < 0.0001 P = 0.0008, and P = 0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6{\%}) recipients developed bacterial sepsis within 3 months. Hypogammaglobulinemia, operative time >14 h, model for end-stage liver disease score >15, and no mycophenolate mofetil use were independent risk factors for developing bacterial sepsis (P = 0.009, P = 0.001, P = 0.003, and P = 0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38-12.0, respectively. Conclusions: Hypogammaglobulinemia within 7 days of LDLT was a significant risk factor for post-transplant bacterial infection and sepsis.",
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T1 - Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis

AU - Yoshizumi, Tomoharu

AU - Shirabe, K.

AU - Ikegami, Toru

AU - Yamashita, N.

AU - Mano, Yohei

AU - Yoshiya, S.

AU - Matono, R.

AU - Harimoto, N.

AU - Uchiyama, H.

AU - Toshima, T.

AU - Maehara, Y.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Several studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis after living-donor liver transplantation (LDLT). Methods: Blood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650 mg/dL within 7 days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3 months after LDLT were analyzed. Results: Fifty (28.2%) recipients experienced bacterial infection within 3 months of LDLT. Eighty-four (47.5%) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15 mmHg were independent risk factors for developing bacterial infection within 3 months of LDLT (P < 0.0001 P = 0.0008, and P = 0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6%) recipients developed bacterial sepsis within 3 months. Hypogammaglobulinemia, operative time >14 h, model for end-stage liver disease score >15, and no mycophenolate mofetil use were independent risk factors for developing bacterial sepsis (P = 0.009, P = 0.001, P = 0.003, and P = 0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38-12.0, respectively. Conclusions: Hypogammaglobulinemia within 7 days of LDLT was a significant risk factor for post-transplant bacterial infection and sepsis.

AB - Background: Several studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis after living-donor liver transplantation (LDLT). Methods: Blood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650 mg/dL within 7 days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3 months after LDLT were analyzed. Results: Fifty (28.2%) recipients experienced bacterial infection within 3 months of LDLT. Eighty-four (47.5%) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15 mmHg were independent risk factors for developing bacterial infection within 3 months of LDLT (P < 0.0001 P = 0.0008, and P = 0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6%) recipients developed bacterial sepsis within 3 months. Hypogammaglobulinemia, operative time >14 h, model for end-stage liver disease score >15, and no mycophenolate mofetil use were independent risk factors for developing bacterial sepsis (P = 0.009, P = 0.001, P = 0.003, and P = 0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38-12.0, respectively. Conclusions: Hypogammaglobulinemia within 7 days of LDLT was a significant risk factor for post-transplant bacterial infection and sepsis.

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