eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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SCImago Journal & Country Rank
3/2019
vol. 15
 
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Hepatology
abstract:
Clinical research

Risk index for early infections following living donor liver transplantation

Shaimaa Elkholy, Doaa Ahmed Mansour, SamahAbd El-Hamid, Ula M. Al-Jarhi, Saeed M. El-Nahaas, Sherif Mogawer

Arch Med Sci 2019; 15 (3): 656–665
Online publish date: 2019/04/30
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Introduction
Post-operative infections in patients undergoing living donor liver transplantation (LDLT) are a major cause of morbidity and mortality. This study aims to develop a practical and efficient prognostic index for early identification and possible prediction of post-transplant infections using risk factors identified by multivariate analysis.

Material and methods
One hundred patients with post-hepatitic cirrhosis, HCV positive, genotype 4, Child B/C or MELD score 13-25 undergoing LDLT were included. All potential predictors of infection were analyzed by backward logistic regression. Cut-off values were obtained from ROC curve analysis. Significant predictors were combined into a risk index, which was further tested and compared by ROC curve analysis.

Results
Post-operative infection was associated with a significantly higher mortality (50.7% vs. 33.3%). Total leucocyte count, total bilirubin, early biliary complications, fever and C-reactive protein were found to be independent predictors of early infectious complications after LDLT. The risk index predicted infection with the highest sensitivity and specificity as compared with each predictor on its own (AUC = 0.91, 95% CI: 0.830–0.955, p < 0.0001).

Conclusions
The use of a combined risk index for early diagnosis of post-operative infections can efficiently identify high risk patients.

keywords:

infections, living donor, liver transplantation

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