Abstract：
BACKGROUND: Normal bile is sterile. Studies have shown that cholangitis after liver transplantation (LT) was associated with a relatively poor prognosis. It remains unclear whether the bacteriobilia or fungibilia impact the patient outcomes in LT recipients, especially with donation after circulatory death (DCD) allografts, which was correlated with a higher risk of allograft failure.
METHODS: This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021. All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia. The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes, especially hospital stay were analyzed.
RESULTS: Totally 135 and 171 organisms were isolated at weeks 1 and 2, respectively. Among all patients included in this analysis, 83 (59.7%) developed bacteriobilia or fungibilia within 2 weeks post-transplantation. The occurrence of bacteriobilia or fungibilia (β = 7.43, 95% CI: 0.02 to 14.82, P = 0.049), particularly the detection of Pseudomonas (β = 18.84, 95% CI: 6.51 to 31.07, P = 0.003) within 2 weeks post-transplantation was associated with a longer hospital stay. However, it did not affect the graft and patient survival.
CONCLUSIONS: The occurrence of bacteriobilia or fungibilia, particularly Pseudomonas within 2 weeks post-transplantation, could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.
METHODS: This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021. All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia. The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes, especially hospital stay were analyzed.
RESULTS: Totally 135 and 171 organisms were isolated at weeks 1 and 2, respectively. Among all patients included in this analysis, 83 (59.7%) developed bacteriobilia or fungibilia within 2 weeks post-transplantation. The occurrence of bacteriobilia or fungibilia (β = 7.43, 95% CI: 0.02 to 14.82, P = 0.049), particularly the detection of Pseudomonas (β = 18.84, 95% CI: 6.51 to 31.07, P = 0.003) within 2 weeks post-transplantation was associated with a longer hospital stay. However, it did not affect the graft and patient survival.
CONCLUSIONS: The occurrence of bacteriobilia or fungibilia, particularly Pseudomonas within 2 weeks post-transplantation, could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.
摘要：
背景：正常胆汁是无菌的。研究表明，肝移植（LT）后胆管炎的预后相对较差。尚不清楚细菌病或真菌是否会影响LT患者的预后。尤其是循环性死亡（DCD）同种异体移植后的捐赠，这与同种异体移植失败的高风险相关。
方法：这项回顾性研究包括2019年至2021年的139名接受DCD移植的LT患者。根据是否存在细菌病或真菌，将所有患者分为两组。术后细菌病或真菌的患病率和微生物谱及其与结局的可能关联，特别是住院时间进行了分析。
结果：在第1周和第2周分别分离出135和171种生物。在本分析中包括的所有患者中，83例（59.7％）在移植后2周内出现了细菌病或真菌。细菌病或真菌的发生（β=7.43，95％CI：0.02至14.82，P=0.049），特别是在移植后2周内检测到假单胞菌(β=18.84,95%CI:6.51~31.07,P=0.003)与住院时间延长相关.然而,它没有影响移植物和患者的生存。
结论：细菌病或真菌的发生，特别是移植后2周内的假单胞菌，可能会影响肝功能的恢复，并且与住院时间延长有关，但与移植物和患者生存率无关。
方法：这项回顾性研究包括2019年至2021年的139名接受DCD移植的LT患者。根据是否存在细菌病或真菌，将所有患者分为两组。术后细菌病或真菌的患病率和微生物谱及其与结局的可能关联，特别是住院时间进行了分析。
结果：在第1周和第2周分别分离出135和171种生物。在本分析中包括的所有患者中，83例（59.7％）在移植后2周内出现了细菌病或真菌。细菌病或真菌的发生（β=7.43，95％CI：0.02至14.82，P=0.049），特别是在移植后2周内检测到假单胞菌(β=18.84,95%CI:6.51~31.07,P=0.003)与住院时间延长相关.然而,它没有影响移植物和患者的生存。
结论：细菌病或真菌的发生，特别是移植后2周内的假单胞菌，可能会影响肝功能的恢复，并且与住院时间延长有关，但与移植物和患者生存率无关。
