Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay: A single-center retrospective observational study in China

Chen-Xue Guo; Jian-Hua Li; Zheng-Xin Wang; Wan-Zhen Li; Jing Zhang; Hao Xing; Su Liu; Tian Wei; Li Li; Rui-Dong Li

doi:10.1016/j.hbpd.2024.04.001

Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay: A single-center retrospective observational study in China

Hepatobiliary Pancreat Dis Int. 2024 Apr 16:S1499-3872(24)00064-X. doi: 10.1016/j.hbpd.2024.04.001. Online ahead of print.

Authors

Chen-Xue Guo¹, Jian-Hua Li², Zheng-Xin Wang², Wan-Zhen Li¹, Jing Zhang³, Hao Xing², Su Liu⁴, Tian Wei², Li Li², Rui-Dong Li⁵

Affiliations

¹ Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Shanghai 200040, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
² Liver Transplantation Center, Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China; Institute of Organ Transplantation, Fudan University, Shanghai 200040, China.
³ Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Shanghai 200040, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China; Clinical Pharmacology Research Center, Huashan Hospital, Fudan University, Shanghai 200040, China.
⁴ Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200040, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200040, China.
⁵ Liver Transplantation Center, Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China; Institute of Organ Transplantation, Fudan University, Shanghai 200040, China; Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address: liruidong@huashan.org.cn.

PMID: 38670871
DOI: 10.1016/j.hbpd.2024.04.001

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.

Keywords: Donor creatinine; Early allograft dysfunction; Intraoperative blood transfusion; Perioperative bleeding; Pseudomonas spp..