Risk Factors for Sepsis Based on Sepsis-3 Criteria after Orthotopic Liver Transplantation

Mediators Inflamm. 2018 Jun 20:2018:8703172. doi: 10.1155/2018/8703172. eCollection 2018.

Abstract

Sepsis is a common complication of solid organ transplant procedures and, in particular, can affect the prognosis of orthotopic liver transplantation (OLT). This retrospective study determined the pre-, peri-, and postoperative risk factors for sepsis after OLT, using as reference the 2016 Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Pre-, peri-, and postoperative clinical data of the sepsis-positive (n = 85) and sepsis-negative (n = 41) groups were analyzed for potential risk factors of OLT-related sepsis. The sepsis-positive patients had a significantly higher rate of dialysis (49.4%), longer time under mechanical ventilation (1.5 d), higher hospitalization costs (0.41 million RMB), and worse survival rate (68.5%), compared with the sepsis-negative patients (4.8%, 1 d, 0.30 million RMB, and 73.1%, resp.). The multivariate logistic analysis identified the following as risk factors for OLT-related sepsis: preoperative Child-Pugh grade C (OR 10.43; 95% CI 2.081-52.292; P = 0.004), preoperative hypercalcemia (OR 6.372; 95% CI 1.693-23.98; P = 0.006), and perioperative acidosis (OR 6.364; 95% CI 1.196-33.869; P = 0.030). Patients with preoperative Child-Pugh grade C, preoperative hypercalcemia, or perioperative acidosis are at higher risk for developing sepsis after OLT. When any of these problems occur, timely sepsis management should be planned.

MeSH terms

  • Acidosis
  • Adult
  • Female
  • Humans
  • Liver Failure / complications
  • Liver Failure / surgery*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Perioperative Period
  • Postoperative Period
  • Preoperative Period
  • Prognosis
  • Renal Dialysis
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Factors
  • Sepsis / complications
  • Sepsis / diagnosis*