Risk factors of bloodstream infections in recipients after liver transplantation: a meta-analysis
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Bloodstream infection (BSI) is an important cause of adverse outcomes for recipients with liver transplantation (LT). This meta-analysis aimed to identify risk factors associated with post-LT BSI.
Relevant studies published up to June 2017 were searched from seven electronic databases. The studies were reviewed according to the inclusion and exclusion criteria. The Z test was used to determine the pooled odds ratio (OR) or standardized mean difference (SMD) of the risk factors. ORs and their corresponding 95% confidence intervals (CIs), or SMDs and their corresponding 95% CIs were used to identify the significant difference of risk factors.
Seventeen studies enrolling 4410 recipients were included. Eleven risk factors were identified to be associated with BSI after LT: male recipient (OR = 1.28), ascites (OR = 1.68), model for end-stage liver disease (MELD) score (SMD = 0.20), Child–Pugh class C (OR = 1.69), operation time (SMD = 0.18), incompatible blood type (OR = 2.87), operative blood loss (SMD = 0.33), rejection (OR = 1.72), biliary complications (OR = 1.91), hemodialysis (OR = 3.37), and retransplantation (OR = 2.86).
Although some risk factors were identified as significant factors for BSI after LT, which may provide a basis for clinical prevention, well-designed prospective studies should be done to overcome the limitations of this study.
KeywordsBloodstream infection Liver transplantation Risk factors Meta-analysis
This work was supported by the National Natural Science Foundation of China (31200064, 31071093, and 31170129).
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
- 11.Singh N, Gayowski T, Wagener MM, Marino I. Bloodstream infections in liver transplant recipients receiving tacrolimus. Clin Transpl. 1997;11:275–81.Google Scholar
- 17.Tai Q, Wu WL, Ju WQ, Wang DP, Wang GD, Ma Y, et al. A 17-year retrospective study of the risk factor of bloodstream infection with MRSA after liver transplantation. J Trop Med 2011:1141–3.Google Scholar
- 19.Bert F, Larroque B, Paugam-Burtz C, Janny S, Durand F, Dondero F, et al. Microbial epidemiology and outcome of bloodstream infections in liver transplant recipients: an analysis of 259 episodes. Liver Transpl. 2010;16:393–401.Google Scholar
- 30.Shi SH, Kong HS, Jia CK, Xu J, Zhang WJ, Wang WL, et al. Coagulase-negative staphylococcus and enterococcus as predominant pathogens in liver transplant recipients with Gram-positive coccal bacteremia. Chin Med J (Engl). 2010;123:1983–8.Google Scholar
- 35.Yan HM, Ji SH, Chen HR, Wang HX, Zhu PY, Xue M, et al. Immune-reconstitution following HLA haplotype related T-cell undepleted allogeneic bone marrow transplantation. J Clin Hematol. 2005;18:7–10.Google Scholar
- 38.Peng Y, Qi XS, Dai JN, Li HY, Guo XZ. Child-Pugh versus MELD score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis. Int J Clin Exp Med. 2015;8:751–7.Google Scholar
- 40.Mor E, Jennings L, Gonwa TA, Holman MJ, Gibbs J, Solomon H, et al. The impact of operative bleeding on outcome in transplantation of the liver. Surg Gynecol Obstet. 1993;176:219–27.Google Scholar