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Title: Changes in surgical site infections after living donor liver transplantation
Authors: Yamamoto, Masaki  kyouindb  KAKEN_id
Takakura, Shunji
Iinuma, Yoshitsugu
Hotta, Go
Matsumura, Yasufumi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-8595-8944 (unconfirmed)
Matsushima, Aki  kyouindb  KAKEN_id
Nagao, Miki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-8886-6145 (unconfirmed)
Ogawa, Kohei
Fujimoto, Yasuhiro
Mori, Akira
Ogura, Yasuhiro
Kaido, Toshimi  kyouindb  KAKEN_id
Uemoto, Shinji  kyouindb  KAKEN_id
Ichiyama, Satoshi
Author's alias: 山本, 正樹
高倉, 俊二
松村, 康史
松島, 晶
長尾, 美紀
小川, 晃平
森, 章
海道, 利実
上本, 伸二
一山, 智
Issue Date: 31-Aug-2015
Publisher: Public Library of Science
Journal title: PLOS ONE
Volume: 10
Issue: 8
Thesis number: e0136559
Abstract: Surgical site infections (SSIs) are a major threat for liver transplant recipients. We prospectively studied SSIs after living donor liver transplantation (LDLT) at Kyoto University Hospital from April 2001 to March 2002 (1st period) and from January 2011 to June 2012 (2nd period). We investigated the epidemiology of SSIs after LDLT and determined the differences between the two periods. A total of 129 adult recipients (66 during the 1st period and 63 during the 2nd period) and 72 pediatric recipients (39 and 33) were included in this study. The SSI rates for each period were 30.3% (1st period) and 41.3% (2nd period) among the adult recipients and 25.6% and 30.3% among the pediatric recipients. The overall rates of 30-day mortality among adult transplant recipients with SSIs were 10.0% (1st period) and 3.9% (2nd period). No pediatric recipient died from SSIs after LDLT in either period. The incidence of Enterococcus faecium increased from 5.0% to 26.9% in the adults and from 10.0% to 40.0% in the pediatric patients. Extended-spectrum p-lactamase-producing Enterobacteriaceae were emerging important isolates during the 2nd period. For this period, a univariate analysis showed that ABO incompatibility (P = 0.02), total operation duration (P = 0.01), graft-to-recipient body weight ratio (GRWR [P = 0.04]), and Roux-en-Y biliary reconstruction (P<0.01) in the adults and age (P = 0.01) and NHSN risk index (P = 0.02) in the children were associated with SSI development. In a multivariate analysis, lower GRWR (P = 0.02) and Roux-en-Y biliary reconstruction (P<0.01) in the adults and older age (P = 0.01) in the children were independent risk factors for SSIs during the 2nd period. In conclusion, SSIs caused by antibiotic resistant bacteria may become a major concern. Lower GRWR and Roux-en-Y biliary reconstruction among adult LDLT recipients and older age among pediatric LDLT recipients increased the risk of developing SSIs after LDLT. Copyright:
Rights: © 2015 Yamamoto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
URI: http://hdl.handle.net/2433/210598
DOI(Published Version): 10.1371/journal.pone.0136559
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