Decreased immunoglobulin G levels after living‐donor liver transplantation is a risk factor for bacterial infection and sepsis. Issue 2 (5th March 2014)

• Record Type: Journal Article
• Authors: Yoshizumi, T.; Shirabe, K.; Ikegami, T.; Yamashita, N.; Mano, Y.; Yoshiya, S.; Matono, R.; Harimoto, N.; Uchiyama, H.; Toshima, T.; Maehara, Y.
• Is Part Of: Transplant infectious disease. Volume 16:Issue 2(2014)
• Page Start: 225
• Page End: 231
• Publication Date: 2014-03-05
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12188
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12188-abs-0001"> <title>Abstract</title> <sec id="tid12188-sec-0001" sec-type="section"> <title>Background</title> <p>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).</p> </sec> <sec id="tid12188-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="tid12188-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> < 0.0001 <italic>P</italic> = 0.0008, and <italic>P</italic> = 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 (<italic>P</italic> = 0.009, <italic>P</italic> = 0.001, <italic>P</italic> = 0.003, and <italic>P</italic> = 0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38–12.0, respectively.</p> </sec> <sec id="tid12188-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Hypogammaglobulinemia within 7 days of LDLT was a significant risk factor for post‐transplant bacterial infection and sepsis.</p> </sec> </abstract>