Analysis of Risk Factors for Bacterial Lung Infection after Orthotopic Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GAOGuo-dong , CAIQiu-cheng , ZHANGXiao-jin ,  JIANGYi

Department of Hepatobiliary Surgery, PLA Fuzhou General Hospital of Nanjing Military Area Command, Fuzhou 350025, Fujian Province, China;

Corresponding author：

JIANGYi, Email: jiangyi8183@163.com

Keywords：

Bacterial lung infection; Risk factor; Liver transplantation; Retrograde reperfusion; Model for end-stage liver disease score

DOI：

10.7507/1007-9424.20140166

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the incidence of bacterial lung infection after orthotopic liver transplantation and its risk factors. Methods Ninety-six patients with end-stage liver disease who underwent liver transplantation from Jan. 2010 to Jun. 2012 in our hospital were retrospectively analyzed. The relationship of preoperative, intraoperative, and postoperative variables with early postoperative bacterial lung infection was explored by multivariate non-conditional logistic regression. Results Twenty-nine cases of 96 cases after liver transplantation occurred early bacterial lung infection, and the infection rate was 30.21%(29/96), in which G-aerobic bacteria infection accounted for 65.52%(19/29), and G+ aerobic bacteria accounted for 34.48%(10/29). Preoperative model for end-stage liver disease score(OR=2.165, P=0.001), intraoperative blood transfusion(OR=1.952, P=0.003), average of plasma creatinine during 3 days after operation(OR=1.913, P=0.001), liquid negative balance time during 3 days after operation(OR=0.916, P=0.023), and postoperative hospital stay(OR=1.923, P=0.003) were all associated with early postoperative bacterial lung infection. Conclusions Retrograde reperfusion in orthotopic liver transplantation patients are susceptible to bacterial lung infections. Improving basic status before operation, controlling volume of intraoperative blood transfusion, the volume of transfusion, and postoperative hospital stay, and improving renal function can reduce incidence of early postoperative bacterial lung infection.

Citation： GAOGuo-dong, CAIQiu-cheng, ZHANGXiao-jin, JIANGYi. Analysis of Risk Factors for Bacterial Lung Infection after Orthotopic Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 693-697. doi: 10.7507/1007-9424.20140166 Copy

1.	王峪,刘懿禾,郑卫萍,等.成人原位肝移植术后早期感染相关危险因素分析[J].中国危重病急救医学, 2006, 18(7):406-408.
2.	Galán Torres JM, Silla Aleixandre I, Chiveli Monleón MA, et al.Premature mortality in the early postoperative period of liver transplantation[J].Rev Esp Anestesiol Reanim, 2003, 50(9):444-450.
3.	Kniepeiss D, Iberer F, Grasser B, et al.A single-center experience with retrograde reperfusion in liver transplantation[J].Transpl Int, 2003, 16(10):730-735.
4.	吕立志,张小进,蔡秋程,等.原位肝移植逆灌注法对术后肺部并发症的影响[J/CD].中华普通外科学文献:电子版, 2011, 5(1):3-6.
5.	郑树森.肝脏移植[M].北京:人民卫生出版社, 2001:441-442.
6.	陈永标,江艺,胡还章,等.肝移植术后肺部感染51例临床分析[J].实用医学杂志, 2007, 23(2):203-204.
7.	曲明,王营,史艳芬,等.重型肝病原位肝移植术后肺部感染的防治[J].实用医药杂志, 2009, 26(5):3-5.
8.	邰强,何晓顺,廖康,等.肝移植术后血行感染中产超广谱β内酰胺酶大肠埃希菌、肺炎克雷伯菌流行病学、细菌学及临床回顾性分析[J/CD].中华普通外科学文献:电子版, 2011, 5(5):421-424.
9.	Matsuki T, Watanabe K, Fujimoto J, et al.Quantitative PCR with 16S rRNA-gene-targeted species-specific primers for analysis of human intestinal bifidobacteria[J].Appl Environ Microbiol, 2004, 70(1):167-173.
10.	吴仲文,徐凯进,李兰娟,等.78例肝硬化患者肠道细菌易位及其相关性研究[J].中华外科杂志, 2006, 44(21):1456-1459.
11.	武正山,钱建民,孔连宝,等.肝移植术后早期肠内营养支持的临床应用[J].中国普外基础与临床杂志, 2004, 11(3):255-256.
12.	林浩铭,李波,霍永忠,等.103例肝移植术后细菌感染危险因素分析[J].中国实用外科杂志, 2005, 25(12):734-736.
13.	牛秀峰,刘军.原位肝移植术后细菌感染的防治[J].中国普外基础与临床杂志, 2008, 15(3):162-165, 179.
14.	杨芳,江艺,吕立志,等.纤维支气管镜与机械通气联合救治肝移植术后重症肺部感染[J].中华肝胆外科杂志, 2008, 14(10):693-695.
15.	丁超峰.活体肝移植治疗良性高MELD评分受体的疗效评价[D].杭州:浙江大学, 2011.
16.	王小明,彭承宏,严佶祺,等.MELD评分与肝移植围手术期并发症及死亡率的相关性[J].中华器官移植杂志, 2007, 28(2):105-107.
17.	Kappa SF, Gorden DL, Davidson MA, et al.Intraoperative blood loss predicts hemorrhage-related reoperation after orthotopic liver transplantation[J].Am Surg, 2010, 76(9):969-973.
18.	谭凯,周杰,张国伟,等.成人首次肝移植术后早期死亡的相关因素分析[J].肝胆胰外科杂志, 2011, 23(5):364-368.
19.	Silliman CC, McLaughlin NJ.Transfusion-related acute lung injury[J].Blood Rev, 2006, 20(3):139-159.
20.	Massicotte L, Sassine MP, Lenis S, et al.Survival rate changes with transfusion of blood products during liver transplantation[J].Can J Anaesth, 2005, 52(2):148-155.
21.	Webert KE, Blajchman MA.Transfusion-related acute lung injury[J].Curr Opin Hematol, 2005, 12(6):480-487.
22.	Singh N, Gayowski T, Wagener MM.Posttransplantation dialysisassociated infections:morbidity and impact on outcome in liver transplant recipients[J].Liver Transpl, 2001, 7(2):100-105.
23.	Lin YH, Cai ZS, Jiang Y, et al.Perioperative risk factors for pulmonary complications after liver transplantation[J].J Int Med Res, 2010, 38(5):1845-1855.
24.	Yost CS, Matthay MA, Gropper MA.Etiology of acute pulmonary edema during liver transplantation:a series of cases with analysis of the edema fluid[J].Chest, 2001, 119(1):219-223.
25.	Pirat A, Ozgur S, Torgay A, et al.Risk factors for postoperative respiratory complications in adult liver transplant recipients[J].Transplant Proc, 2004, 36(1):218-220.
26.	蔡志仕,江艺,吕立志,等.肝移植围手术期的危险因素与术后肺部并发症的关系分析[J].临床外科杂志, 2008, 16(12):808-810.
27.	蒋进发,魏思东,陈国勇.肝移植术后肺部感染的临床分析[J].临床医学, 2012, 32(5):4-5.
28.	王智慧,张水军,郭文治,等.肝移植术后肺部感染的临床分析[J].中国实用医刊, 2013, 40(12):10-12.

1. 王峪,刘懿禾,郑卫萍,等.成人原位肝移植术后早期感染相关危险因素分析[J].中国危重病急救医学, 2006, 18(7):406-408.
2. Galán Torres JM, Silla Aleixandre I, Chiveli Monleón MA, et al.Premature mortality in the early postoperative period of liver transplantation[J].Rev Esp Anestesiol Reanim, 2003, 50(9):444-450.
3. Kniepeiss D, Iberer F, Grasser B, et al.A single-center experience with retrograde reperfusion in liver transplantation[J].Transpl Int, 2003, 16(10):730-735.
4. 吕立志,张小进,蔡秋程,等.原位肝移植逆灌注法对术后肺部并发症的影响[J/CD].中华普通外科学文献:电子版, 2011, 5(1):3-6.
5. 郑树森.肝脏移植[M].北京:人民卫生出版社, 2001:441-442.
6. 陈永标,江艺,胡还章,等.肝移植术后肺部感染51例临床分析[J].实用医学杂志, 2007, 23(2):203-204.
7. 曲明,王营,史艳芬,等.重型肝病原位肝移植术后肺部感染的防治[J].实用医药杂志, 2009, 26(5):3-5.
8. 邰强,何晓顺,廖康,等.肝移植术后血行感染中产超广谱β内酰胺酶大肠埃希菌、肺炎克雷伯菌流行病学、细菌学及临床回顾性分析[J/CD].中华普通外科学文献:电子版, 2011, 5(5):421-424.
9. Matsuki T, Watanabe K, Fujimoto J, et al.Quantitative PCR with 16S rRNA-gene-targeted species-specific primers for analysis of human intestinal bifidobacteria[J].Appl Environ Microbiol, 2004, 70(1):167-173.
10. 吴仲文,徐凯进,李兰娟,等.78例肝硬化患者肠道细菌易位及其相关性研究[J].中华外科杂志, 2006, 44(21):1456-1459.
11. 武正山,钱建民,孔连宝,等.肝移植术后早期肠内营养支持的临床应用[J].中国普外基础与临床杂志, 2004, 11(3):255-256.
12. 林浩铭,李波,霍永忠,等.103例肝移植术后细菌感染危险因素分析[J].中国实用外科杂志, 2005, 25(12):734-736.
13. 牛秀峰,刘军.原位肝移植术后细菌感染的防治[J].中国普外基础与临床杂志, 2008, 15(3):162-165, 179.
14. 杨芳,江艺,吕立志,等.纤维支气管镜与机械通气联合救治肝移植术后重症肺部感染[J].中华肝胆外科杂志, 2008, 14(10):693-695.
15. 丁超峰.活体肝移植治疗良性高MELD评分受体的疗效评价[D].杭州:浙江大学, 2011.
16. 王小明,彭承宏,严佶祺,等.MELD评分与肝移植围手术期并发症及死亡率的相关性[J].中华器官移植杂志, 2007, 28(2):105-107.
17. Kappa SF, Gorden DL, Davidson MA, et al.Intraoperative blood loss predicts hemorrhage-related reoperation after orthotopic liver transplantation[J].Am Surg, 2010, 76(9):969-973.
18. 谭凯,周杰,张国伟,等.成人首次肝移植术后早期死亡的相关因素分析[J].肝胆胰外科杂志, 2011, 23(5):364-368.
19. Silliman CC, McLaughlin NJ.Transfusion-related acute lung injury[J].Blood Rev, 2006, 20(3):139-159.
20. Massicotte L, Sassine MP, Lenis S, et al.Survival rate changes with transfusion of blood products during liver transplantation[J].Can J Anaesth, 2005, 52(2):148-155.
21. Webert KE, Blajchman MA.Transfusion-related acute lung injury[J].Curr Opin Hematol, 2005, 12(6):480-487.
22. Singh N, Gayowski T, Wagener MM.Posttransplantation dialysisassociated infections:morbidity and impact on outcome in liver transplant recipients[J].Liver Transpl, 2001, 7(2):100-105.
23. Lin YH, Cai ZS, Jiang Y, et al.Perioperative risk factors for pulmonary complications after liver transplantation[J].J Int Med Res, 2010, 38(5):1845-1855.
24. Yost CS, Matthay MA, Gropper MA.Etiology of acute pulmonary edema during liver transplantation:a series of cases with analysis of the edema fluid[J].Chest, 2001, 119(1):219-223.
25. Pirat A, Ozgur S, Torgay A, et al.Risk factors for postoperative respiratory complications in adult liver transplant recipients[J].Transplant Proc, 2004, 36(1):218-220.
26. 蔡志仕,江艺,吕立志,等.肝移植围手术期的危险因素与术后肺部并发症的关系分析[J].临床外科杂志, 2008, 16(12):808-810.
27. 蒋进发,魏思东,陈国勇.肝移植术后肺部感染的临床分析[J].临床医学, 2012, 32(5):4-5.
28. 王智慧,张水军,郭文治,等.肝移植术后肺部感染的临床分析[J].中国实用医刊, 2013, 40(12):10-12.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Risk Factors for Bacterial Lung Infection after Orthotopic Liver Transplantation

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content