Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Nutrition. 2012 Nov-Dec;28(11-12):1104-8. doi: 10.1016/j.nut.2012.02.007.
Infectious complications, including sepsis, that often occur after liver transplantation (LT) comprise the most frequent causes of in-hospital death. This study investigated the predictors of post-transplantation infectious complications to establish a strategy with which to improve short-term outcomes after LT.
We used univariate and multivariate analyses to assess pre- and perioperative risk factors for post-transplantation infectious complications in 100 consecutive patients who underwent living donor LT from February 2008 through February 2010 at our institute.
Multivariate analysis showed that low preoperative body cell mass and the absence of preoperative supplementation with branched-chain amino acids were of prognostic significance for post-transplantation sepsis. In addition, Child-Pugh classification C and massive operative blood loss were independent risk factors for post-transplantation bacteremia, and preoperative low body cell mass was an independent risk factor for in-hospital death from infection.
Pretransplantation nutritional intervention and decreases in operative blood loss would help prevent post-transplantation infectious complications from developing during living donor LT. Branched-chain amino acid supplementation before LT affects the occurrence of infectious complications.
肝移植（LT）后常发生感染并发症，包括败血症，是导致院内死亡的最常见原因。本研究旨在探讨移植后感染并发症的预测因素，以制定改善 LT 后短期预后的策略。
我们使用单因素和多因素分析评估了 2008 年 2 月至 2010 年 2 月期间我院 100 例连续行活体供肝 LT 的患者的术前和围手术期感染并发症的危险因素。
多因素分析表明，术前低体细胞质量和未术前补充支链氨基酸与移植后败血症的预后有关。此外，Child-Pugh 分级 C 和大量手术失血是移植后菌血症的独立危险因素，而术前低体细胞质量是感染性院内死亡的独立危险因素。
移植前的营养干预和减少手术失血有助于预防活体供肝 LT 后感染性并发症的发生。LT 前补充支链氨基酸会影响感染性并发症的发生。
