Colonna J O, Winston D J, Brill J E, Goldstein L I, Hoff M P, Hiatt J R, Quinones-Baldrich W, Ramming K P, Busuttil R W
Department of Surgery, UCLA-Center for the Health Sciences 90024.
Arch Surg. 1988 Mar;123(3):360-4. doi: 10.1001/archsurg.1988.01400270094015.
Thirty-five patients received 42 liver homografts between February 1984 and August 1985. One or more infections developed in 23 patients (66%) some time after transplantation. An average of 2.5 infections per infected patient occurred. Of 37 bacterial infections, two thirds were either bacteremias or localized intra-abdominal infections. The median onset was 29 days after operation. Thirteen viral infections were identified, with a median onset of 18 days after operation. Nine fungal infections, six disseminated and three localized, were identified, with a median onset of nine days after operation. Infection was the primary cause of death in five (14%) of 35 patients. Fatal infections were evenly distributed among bacterial (two), fungal (three), and viral (two) pathogens. Despite advances in surgical techniques and the use of cyclosporine, infection after orthotopic liver transplantation is a serious problem. Certain patients can be identified as high risks for infection and require an aggressive diagnostic workup followed by early institution of antimicrobial therapy.
1984年2月至1985年8月期间，35例患者接受了42次肝脏同种移植。23例患者（66%）在移植后的某个时间发生了一种或多种感染。每例感染患者平均发生2.5次感染。在37例细菌感染中，三分之二为菌血症或局限性腹腔内感染。中位发病时间为术后29天。确定了13例病毒感染，中位发病时间为术后18天。确定了9例真菌感染，其中6例为播散性感染，3例为局限性感染，中位发病时间为术后9天。感染是35例患者中5例（14%）死亡的主要原因。致命感染在细菌（2例）、真菌（3例）和病毒（2例）病原体中分布均匀。尽管手术技术有所进步且使用了环孢素，但原位肝移植后的感染仍是一个严重问题。某些患者可被确定为感染高危人群，需要积极的诊断检查，随后尽早开始抗菌治疗。
