Sepsis Following Liver Biopsy in a Liver Transplant Recipient: Case Report and Review of Literature.

肝移植受者肝活检后脓毒症 ： 病例报告和文献复习。

• 发表时间: Mar-Apr 2021
• 来源期刊: J Clin Exp Hepatol
• DOI: 10.1016/j.jceh.2020.07.005
• PMID: 33746451
• 文章类型: Journal Article
• 作者列表: Agrawal L,Jain S,Madhusudhan KS,Das P,Shalimar ,Dash NR,Sahni P,Pal S

关键词: ALT, Alanine transaminase; AST, Aspartate transaminase; BD, Twice daily; DDLT, Deceased donor liver transplant; FFP, Fresh frozen plasma; I.V., Intravenous; LFTs, Liver function tests; LT, Liver transplant; MMF, Mycophenolate mofetil; MRCP, Magnetic resonance cholangiopancreatography; MRI, Magnetic resonance imaging; MU, Million units; OD, Once daily; PSC, Primary sclerosing cholangitis; PTBD, Percutaneous transhepatic biliary drainage; TDS, Three times daily; TLC, Total leucocyte count; liver biopsy; liver transplantation; sepsis

Abstract

Percutaneous liver biopsy is a relatively safe procedure with low complication rates. Infections following liver biopsy are uncommon and can lead to a poor outcome. There are limited data on liver biopsy-related infections among liver transplant (LT) recipients. Also, there is a paucity of data regarding the use of prophylactic antibiotics in LT patients undergoing percutaneous liver biopsy. We report a case of systemic sepsis following percutaneous liver biopsy in a LT recipient with choledochojejunal anastomosis. This was followed by severe rejection and deterioration of liver function and recurrence of primary sclerosing cholangitis (PSC) to the extent that he has been listed for retransplantation. This case report emphasizes the potential risk of sepsis in LT recipients with bilioenteric anastomosis undergoing percutaneous liver biopsy. This increased risk may warrant periprocedural broad spectrum antibiotic prophylaxis, in this subgroup of patients.

摘要

经皮肝活检是一种相对安全的手术，并发症发生率低。肝活检后的感染并不常见，可能导致不良结果。关于肝移植（LT）受者中肝活检相关感染的数据有限。此外，关于在接受经皮肝活检的LT患者中使用预防性抗生素的数据很少.我们报告了一例胆总管空肠吻合术的LT受体经皮肝活检后全身性败血症。随后是严重的排斥反应和肝功能恶化以及原发性硬化性胆管炎（PSC）的复发，以至于他已被列为再次移植。该病例报告强调了经皮肝活检胆肠吻合术的LT受体败血症的潜在风险。这种增加的风险可能需要围手术期广谱抗生素预防，在这个亚组的患者中。