Romero Fabian A, Razonable Raymund R
Fabian A Romero, Raymund R Razonable, Division of Infectious Diseases and the William J von Liebig Transplant Center, Mayo Clinic, Rochester, MN 55905, United States.
World J Hepatol. 2011 Apr 27;3(4):83-92. doi: 10.4254/wjh.v3.i4.83.
Liver transplantation is a standard life-saving procedure for the treatment of many end-stage liver diseases. The success of this procedure may be limited by infectious complications. In this article, we review the contemporary state of infectious complications during the post-operative period, with particular emphasis on those that occur most commonly during the first 6 mo after liver transplantation. Bacteria, and less commonly Candida infections, remain the predominant pathogens during the immediate post-operative period, especially during the first month, and infections caused by drug-resistant strains are emerging. Infections caused by cytomegalovirus and Aspergillus sp. present clinically during the "opportunistic" period characterized by intense immunosuppression. As newer potent immunosuppressive therapies with the major aim of reducing allograft rejection are developed, one potential adverse effect is an increase in certain infections. Hence, it is essential for liver transplant centers to have an effective approach to prevention that is based on predicted infection risk, local antimicrobial resistance patterns, and surveillance. A better understanding of the common and most important infectious complications is anticipated to lead to improvements in quality of life and survival of liver transplant recipients.
肝移植是治疗多种终末期肝病的标准挽救生命的手术。该手术的成功可能会受到感染性并发症的限制。在本文中，我们回顾了术后感染性并发症的当代现状，特别强调了肝移植后最初6个月内最常见的那些并发症。细菌，以及较少见的念珠菌感染，仍然是术后即刻尤其是第一个月期间的主要病原体，并且耐药菌株引起的感染正在出现。巨细胞病毒和曲霉属引起的感染在以强烈免疫抑制为特征的“机会性”时期出现临床症状。随着以减少移植排斥为主要目标的新型强效免疫抑制疗法的发展，一个潜在的不良反应是某些感染的增加。因此，肝移植中心必须基于预测的感染风险、当地的抗菌药物耐药模式和监测，制定有效的预防方法。对常见且最重要的感染性并发症有更好的了解有望改善肝移植受者的生活质量和生存率。
