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Langenbecks Arch Surg ; 403(4): 509-519, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29696373

RESUMEN

PURPOSE: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factors during the early post-transplant period might help to improve prevention of viral infections after LT. METHODS: Between 2004 and 2010, 530 adult patients underwent LT at a large university hospital serving a metropolitan region in Europe. This retrospective single-centre study analysed putative risk factors for early viral infections with herpes simplex virus-1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), hepatitis A/B/C (HAV/HBV/HCV) and cytomegalovirus (CMV) in the first 3 months after LT. RESULTS: The final analysis included 501 patients of whom 126 (25.1%) had documented viral infections after LT. No significant differences could be detected between patients with or without viral infections concerning 30- and 90-day mortality. Risk factors in the early post-transplant period identified by multivariate analysis included female gender (CMV, HSV-1), the post-operative need for continuous veno-venous hemofiltration (CMV), septic shock (CMV), detection of fungi (CMV) and the intraoperative amount of transfused blood (EBV). CONCLUSIONS: Enhanced vigilance regarding opportunistic infections is crucial in the management of this high-risk population of immunocompromised patients. In particular, attention should be paid to avoidable conditions that increase the risk of renal replacement therapies in the post-LT setting, especially among women. TRIAL REGISTRATION: DRKS00010672 on German Clinical Trial Register.


Asunto(s)
Hepatitis Viral Humana/etiología , Infecciones por Herpesviridae/etiología , Hepatopatías/cirugía , Trasplante de Hígado/efectos adversos , Complicaciones Posoperatorias/virología , Adulto , Femenino , Virus de Hepatitis , Hepatitis Viral Humana/mortalidad , Herpesviridae , Infecciones por Herpesviridae/mortalidad , Humanos , Hepatopatías/complicaciones , Hepatopatías/mortalidad , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
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