Source:http://linkedlifedata.com/resource/pubmed/id/15023150
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
4
|
| pubmed:dateCreated |
2004-3-16
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| pubmed:abstractText |
Bilomas, infected hepatic fluid collections, are a frequent complication of liver transplantation. We report a case-control cohort study to determine the incidence and microbiologic profile of bilomas and risk factors for biloma formation in 492 patients undergoing liver transplantation from 1994 to 2001. Fifty-seven patients (11.5%) developed one or more bilomas; 95% in the first year post-transplantation. The most common initial infecting pathogens were enterococci (37%), one-half resistant to vancomycin (VRE); coagulase-negative staphylococci (26%); and Candida species (26%). Infection by coagulase-negative staphylococci was strongly associated with the presence of a T-tube (OR 9.60, p=0.02). In stepwise logistic regression multivariable analyses, hepatic artery thrombosis (OR 90.9, p<0.0001), hepatic artery stenosis (OR 13.2, p<0.0001) and Roux-en-Y choledochojejunostomy (OR 5.8, p=0.03) were independent risk factors for biloma formation; ursodeoxycholic acid use was highly protective (OR 0.1, p=0.002). Strategies to prevent biloma formation must focus on measures to prevent hepatic artery thrombosis and colonization of liver transplant patients by multiresistant nosocomial pathogens. T-tube drainage post-transplantation bears reassessment. The protective effect of ursodeoxycholic acid found in this study warrants confirmation in a prospective multicenter, randomized trial.
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| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Apr
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| pubmed:issn |
1600-6135
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
4
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
574-82
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| pubmed:dateRevised |
2007-2-14
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| pubmed:meshHeading |
pubmed-meshheading:15023150-Candidiasis,
pubmed-meshheading:15023150-Case-Control Studies,
pubmed-meshheading:15023150-Cohort Studies,
pubmed-meshheading:15023150-Constriction, Pathologic,
pubmed-meshheading:15023150-Drug Resistance, Bacterial,
pubmed-meshheading:15023150-Female,
pubmed-meshheading:15023150-Gram-Positive Bacterial Infections,
pubmed-meshheading:15023150-Humans,
pubmed-meshheading:15023150-Liver,
pubmed-meshheading:15023150-Liver Diseases,
pubmed-meshheading:15023150-Liver Transplantation,
pubmed-meshheading:15023150-Male,
pubmed-meshheading:15023150-Middle Aged,
pubmed-meshheading:15023150-Multivariate Analysis,
pubmed-meshheading:15023150-Odds Ratio,
pubmed-meshheading:15023150-Risk Factors,
pubmed-meshheading:15023150-Staphylococcal Infections,
pubmed-meshheading:15023150-Time Factors,
pubmed-meshheading:15023150-Tomography, X-Ray Computed,
pubmed-meshheading:15023150-Vancomycin
|
| pubmed:year |
2004
|
| pubmed:articleTitle |
Infected bilomas in liver transplant recipients, incidence, risk factors and implications for prevention.
|
| pubmed:affiliation |
Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|