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：

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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,劉懿禾,鄭衛萍,等.成人原位肝移植術后早期感染相關危險因素分析[J].中國危重病急救醫學, 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.	呂立志,張小進,蔡秋程,等.原位肝移植逆灌注法對術后肺部并發癥的影響[J/CD].中華普通外科學文獻:電子版, 2011, 5(1):3-6.
5.	鄭樹森.肝臟移植[M].北京:人民衛生出版社, 2001:441-442.
6.	陳永標,江藝,胡還章,等.肝移植術后肺部感染51例臨床分析[J].實用醫學雜志, 2007, 23(2):203-204.
7.	曲明,王營,史艷芬,等.重型肝病原位肝移植術后肺部感染的防治[J].實用醫藥雜志, 2009, 26(5):3-5.
8.	邰強,何曉順,廖康,等.肝移植術后血行感染中產超廣譜β內酰胺酶大腸埃希菌、肺炎克雷伯菌流行病學、細菌學及臨床回顧性分析[J/CD].中華普通外科學文獻:電子版, 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.	吳仲文,徐凱進,李蘭娟,等.78例肝硬化患者腸道細菌易位及其相關性研究[J].中華外科雜志, 2006, 44(21):1456-1459.
11.	武正山,錢建民,孔連寶,等.肝移植術后早期腸內營養支持的臨床應用[J].中國普外基礎與臨床雜志, 2004, 11(3):255-256.
12.	林浩銘,李波,霍永忠,等.103例肝移植術后細菌感染危險因素分析[J].中國實用外科雜志, 2005, 25(12):734-736.
13.	牛秀峰,劉軍.原位肝移植術后細菌感染的防治[J].中國普外基礎與臨床雜志, 2008, 15(3):162-165, 179.
14.	楊芳,江藝,呂立志,等.纖維支氣管鏡與機械通氣聯合救治肝移植術后重癥肺部感染[J].中華肝膽外科雜志, 2008, 14(10):693-695.
15.	丁超峰.活體肝移植治療良性高MELD評分受體的療效評價[D].杭州:浙江大學, 2011.
16.	王小明,彭承宏,嚴佶祺,等.MELD評分與肝移植圍手術期并發癥及死亡率的相關性[J].中華器官移植雜志, 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.	譚凱,周杰,張國偉,等.成人首次肝移植術后早期死亡的相關因素分析[J].肝膽胰外科雜志, 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,江藝,呂立志,等.肝移植圍手術期的危險因素與術后肺部并發癥的關系分析[J].臨床外科雜志, 2008, 16(12):808-810.
27.	蔣進發,魏思東,陳國勇.肝移植術后肺部感染的臨床分析[J].臨床醫學, 2012, 32(5):4-5.
28.	王智慧,張水軍,郭文治,等.肝移植術后肺部感染的臨床分析[J].中國實用醫刊, 2013, 40(12):10-12.

1. ?王峪,劉懿禾,鄭衛萍,等.成人原位肝移植術后早期感染相關危險因素分析[J].中國危重病急救醫學, 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. 呂立志,張小進,蔡秋程,等.原位肝移植逆灌注法對術后肺部并發癥的影響[J/CD].中華普通外科學文獻:電子版, 2011, 5(1):3-6.
5. 鄭樹森.肝臟移植[M].北京:人民衛生出版社, 2001:441-442.
6. 陳永標,江藝,胡還章,等.肝移植術后肺部感染51例臨床分析[J].實用醫學雜志, 2007, 23(2):203-204.
7. 曲明,王營,史艷芬,等.重型肝病原位肝移植術后肺部感染的防治[J].實用醫藥雜志, 2009, 26(5):3-5.
8. 邰強,何曉順,廖康,等.肝移植術后血行感染中產超廣譜β內酰胺酶大腸埃希菌、肺炎克雷伯菌流行病學、細菌學及臨床回顧性分析[J/CD].中華普通外科學文獻:電子版, 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. 吳仲文,徐凱進,李蘭娟,等.78例肝硬化患者腸道細菌易位及其相關性研究[J].中華外科雜志, 2006, 44(21):1456-1459.
11. 武正山,錢建民,孔連寶,等.肝移植術后早期腸內營養支持的臨床應用[J].中國普外基礎與臨床雜志, 2004, 11(3):255-256.
12. 林浩銘,李波,霍永忠,等.103例肝移植術后細菌感染危險因素分析[J].中國實用外科雜志, 2005, 25(12):734-736.
13. 牛秀峰,劉軍.原位肝移植術后細菌感染的防治[J].中國普外基礎與臨床雜志, 2008, 15(3):162-165, 179.
14. 楊芳,江藝,呂立志,等.纖維支氣管鏡與機械通氣聯合救治肝移植術后重癥肺部感染[J].中華肝膽外科雜志, 2008, 14(10):693-695.
15. 丁超峰.活體肝移植治療良性高MELD評分受體的療效評價[D].杭州:浙江大學, 2011.
16. 王小明,彭承宏,嚴佶祺,等.MELD評分與肝移植圍手術期并發癥及死亡率的相關性[J].中華器官移植雜志, 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. 譚凱,周杰,張國偉,等.成人首次肝移植術后早期死亡的相關因素分析[J].肝膽胰外科雜志, 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,江藝,呂立志,等.肝移植圍手術期的危險因素與術后肺部并發癥的關系分析[J].臨床外科雜志, 2008, 16(12):808-810.
27. 蔣進發,魏思東,陳國勇.肝移植術后肺部感染的臨床分析[J].臨床醫學, 2012, 32(5):4-5.
28. 王智慧,張水軍,郭文治,等.肝移植術后肺部感染的臨床分析[J].中國實用醫刊, 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

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