Infectious Complications Following Small Bowel Transplantation. [artículo]
Por: Silva, J.T [Unidad de Enfermedades Infecciosas ]
| San Juan Garrido, Rafael [Medicina Interna] | Fernández Ruiz, Mario [Medicina Interna] | Lumbreras Bermejo, Carlos [Medicina Interna] | Calvo Pulido, Jorge [Cirugía General y del Aparato Digestivo] | Jiménez Romero, Carlos [Cirugía General y del Aparato Digestivo] | López Medrano, Francisco [Enfermedades Infecciosas] | Aguado García, José María [Enfermedades Infecciosas].
Colaborador(es): Servicio de Medicina Interna | Servicio de Cirugía General y del Aparato Digestivo | Instituto de Investigación imas12.
Tipo de material: 
ArtículoEditor: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2016Descripción: 16(3):951-9.Recursos en línea: Solicitar documento Resumen: Microbiological spectrum and outcome of infectious complications following small bowel transplantation (SBT) have not been thoroughly characterized. We performed a retrospective analysis of all patients undergoing SBT from 2004 to 2013 in Spain. Sixty-nine patients underwent a total of 87 SBT procedures (65 pediatric, 22 adult). The median follow-up was 867 days. Overall, 81 transplant patients (93.1%) developed 263 episodes of infection (incidence rate: 2.81 episodes per 1000 transplant-days), with no significant differences between adult and pediatric populations. Most infections were bacterial (47.5%). Despite universal prophylaxis, 22 transplant patients (25.3%) developed cytomegalovirus disease, mainly in the form of enteritis. Specifically, 54 episodes of opportunistic infection (OI) occurred in 35 transplant patients. Infection was the major cause of mortality (17 of 24 deaths). Multivariate analysis identified retransplantation (hazard ratio [HR]: 2.21; 95% confidence interval [CI]: 1.02-4.80; p = 0.046) and posttransplant renal replacement therapy (RRT; HR: 4.19; 95% CI: 1.40-12.60; p = 0.011) as risk factors for OI. RRT was also a risk factor for invasive fungal disease (IFD; HR: 24.90; 95% CI: 5.35-115.91; p < 0.001). In conclusion, infection is the most frequent complication and the leading cause of death following SBT. Posttransplant RRT and retransplantation identify those recipients at high risk for developing OI and IFD.
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|---|---|---|---|---|
Artículo
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Navegando Hospital Universitario 12 de Octubre Estantes Cerrar el navegador de estanterías
Formato Vancouver:
Silva JT, San-Juan R, Fernández Caamaño B, Prieto Bozano G, Fernández Ruiz M, Lumbreras C et al. Infectious Complications Following Small Bowel Transplantation. Am J Transplant. 2016 Mar;16(3):951-9.
PMID: 26560685
Contiene 31 referencias
Microbiological spectrum and outcome of infectious complications following small bowel transplantation (SBT) have not been thoroughly characterized. We performed a retrospective analysis of all patients undergoing SBT from 2004 to 2013 in Spain. Sixty-nine patients underwent a total of 87 SBT procedures (65 pediatric, 22 adult). The median follow-up was 867 days. Overall, 81 transplant patients (93.1%) developed 263 episodes of infection (incidence rate: 2.81 episodes per 1000 transplant-days), with no significant differences between adult and pediatric populations. Most infections were bacterial (47.5%). Despite universal prophylaxis, 22 transplant patients (25.3%) developed cytomegalovirus disease, mainly in the form of enteritis. Specifically, 54 episodes of opportunistic infection (OI) occurred in 35 transplant patients. Infection was the major cause of mortality (17 of 24 deaths). Multivariate analysis identified retransplantation (hazard ratio [HR]: 2.21; 95% confidence interval [CI]: 1.02-4.80; p = 0.046) and posttransplant renal replacement therapy (RRT; HR: 4.19; 95% CI: 1.40-12.60; p = 0.011) as risk factors for OI. RRT was also a risk factor for invasive fungal disease (IFD; HR: 24.90; 95% CI: 5.35-115.91; p < 0.001). In conclusion, infection is the most frequent complication and the leading cause of death following SBT. Posttransplant RRT and retransplantation identify those recipients at high risk for developing OI and IFD.
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