期刊
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY
卷 26, 期 1, 页码 61-72出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.bpg.2012.01.004
关键词
Liver transplantation; Infection; Bacteria; Virus; Fungus; Risk factors; Donor; Recipient; Innate immunity; Toll-like receptors; Complement; Mannan-binding lectin; Ficolin; MBL-associated serine proteases
资金
- MD Clinical Research Trainee (AGIKO) ZonMw (The Netherlands Organisation for Health Research and Development) [40-00703-98-10578]
- Dutch Digestive Foundation [W007-18]
- Leiden University Medical Center
Infection is a common cause of morbidity and mortality after liver transplantation. Risk factors relate to transplantation factors, donor and recipient factors. Transplant factors include ischaemia-reperfusion damage, amount of intra-operative blood transfusion, level and type of immunosuppression, rejection, and complications, prolonged intensive care stay with dialysis or ventilation, type of biliary drainage, repeat operations, re-transplantation, antibiotics, antiviral regimen, and environment. Donor risk factors include infection, prolonged intensive care stay, quality of the donor liver (e.g. steatosis), and viral status. For the recipient the most important are MELD score >30, malnutrition, renal failure, acute liver failure, presence of infection or colonisation, and immune status for viruses like cytomegalovirus. In recent years it has become clear that genetic polymorphisms in innate immunity, especially the lectin pathway of complement activation and in Toll-like receptors importantly contribute to the infection risk after liver transplantation. Therefore, the risk for infections after liver transplantation is a multifactorial problem and all factors need attention to reduce this risk. (c) 2012 Elsevier Ltd. All rights reserved.
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