Yoshiya Shohei, Itoh Shinji, Toshima Takeo, Bekki Yuki, Izumi Takuma, Iseda Norifumi, Tsutsui Yuriko, Toshida Katsuya, Nakayama Yuki, Ishikawa Takuma, Yoshizumi Tomoharu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Surg Today. 2025 Apr;55(4):475-482. doi: 10.1007/s00595-024-02918-7. Epub 2024 Aug 19.
Infectious complications, particularly post-transplant sepsis, have a critical impact on postoperative outcomes. This study examined the effects of perioperative synbiotic treatment on postoperative outcomes in patients receiving early enteral nutrition.
We reviewed 210 living-donor liver transplantation procedures and retrospectively analyzed the postoperative outcomes with and without perioperative synbiotic treatment (live lactic acid bacteria, bifidobacteria, and oligosaccharides) 5 days before and after living-donor liver transplantation.
The synbiotic group (n = 34) had significantly fewer male donors (38.2% vs. 61.9%, p = 0.011) and a higher proportion of ABO-incompatible grafts (52.9% vs. 25.6%, p = 0.021) than the non-synbiotic group (n = 176). The incidence of sepsis was significantly lower in the synbiotic group than in the non-synbiotic group (0% vs. 7.4%, p = 0.029), with a lower incidence rate of sepsis due to bacteremia with intestinal bacteria (0% vs. 4.6%, p = 0.089). There were no significant differences in the proportions of acute rejection, small-for-size graft syndrome, or postoperative liver function between the two groups. Furthermore, there was no significant difference in the graft survival rates after LDLT between two groups. (p = 0.24).
Perioperative synbiotic treatment prevents post-transplant sepsis, even with early enteral nutrition.
感染性并发症，尤其是移植后脓毒症，对术后结局有至关重要的影响。本研究探讨围手术期合生元治疗对接受早期肠内营养患者术后结局的影响。
我们回顾了210例活体肝移植手术，并对活体肝移植前后5天接受和未接受围手术期合生元治疗（活性乳酸菌、双歧杆菌和低聚糖）的患者术后结局进行了回顾性分析。
与非合生元组（n = 176）相比，合生元组（n = 34）男性供体显著更少（38.2%对61.9%，p = 0.011），ABO血型不相容移植物比例更高（52.9%对25.6%，p = 0.021）。合生元组脓毒症发生率显著低于非合生元组（0%对7.4%，p = 0.029），因肠道细菌菌血症导致的脓毒症发生率更低（0%对4.6%，p = 0.089）。两组在急性排斥反应、小体积移植物综合征或术后肝功能比例方面无显著差异。此外，两组活体肝移植后移植物存活率无显著差异（p = 0.24）。
围手术期合生元治疗可预防移植后脓毒症，即使是在早期肠内营养的情况下。
