Rayes Nada, Seehofer Daniel, Theruvath Tom, Schiller Reinhold A, Langrehr Jan M, Jonas Sven, Bengmark Stig, Neuhaus Peter
Department of General, Visceral and Transplant Surgery, Charite Campus Virchow, Humboldt University, Berlin, Germany.
Am J Transplant. 2005 Jan;5(1):125-30. doi: 10.1111/j.1600-6143.2004.00649.x.
Bacterial infections frequently occur early after liver transplantation. We recently reported significant progress with a synbiotic composition, consisting of one lactic acid bacteria (LAB) and one fiber, which reduced the infection rate from 48% (with selective bowel decontamination) to 13%. Now, our aim is to study if a combination of different LAB and fibers would further improve outcome. A prospective randomized double-blind trial was undertaken in 66 liver transplant recipients. All patients received enteral nutrition immediately post-operatively. Comparison was made between one group (A) receiving a composition of four LAB and four fibers and another group (B) receiving the fibers only. The treatment started the day before surgery and continued for 14 days. Thirty-day infection rate, length of hospital stay, duration of antibiotic therapy, non-infectious complications and side effects of enteral nutrition were recorded. The incidence of post-operative bacterial infections was significantly reduced; being 48% with only fibers and 3% with LAB and fibers. In addition, the duration of antibiotic therapy was significantly shorter in the latter group. In both groups, mainly mild or moderate infections occurred. Fibers and LAB were well tolerated. Early enteral nutrition supplemented with a mixture of LAB and fibers reduces bacterial infection rates following liver transplantation. Treatment with only fibers led to a low incidence of severe infections.
细菌感染在肝移植后早期经常发生。我们最近报告了一种合生元组合取得的显著进展，该组合由一种乳酸菌（LAB）和一种纤维组成，它将感染率从48%（采用选择性肠道去污时）降低到了13%。现在，我们的目标是研究不同乳酸菌和纤维的组合是否会进一步改善治疗结果。对66名肝移植受者进行了一项前瞻性随机双盲试验。所有患者术后立即接受肠内营养。对一组（A组）接受四种乳酸菌和四种纤维组合的患者与另一组（B组）仅接受纤维的患者进行了比较。治疗在手术前一天开始，持续14天。记录了30天感染率、住院时间、抗生素治疗持续时间、非感染性并发症以及肠内营养的副作用。术后细菌感染的发生率显著降低；仅接受纤维治疗时为48%，接受乳酸菌和纤维治疗时为3%。此外，后一组的抗生素治疗持续时间明显更短。在两组中，主要发生的是轻度或中度感染。纤维和乳酸菌的耐受性良好。早期肠内营养补充乳酸菌和纤维的混合物可降低肝移植后的细菌感染率。仅用纤维治疗导致严重感染的发生率较低。
