Kibbler C C
Royal Free Hospital, London, UK.
J Hosp Infect. 1995 Jun;30 Suppl:209-17. doi: 10.1016/0195-6701(95)90021-7.
Infection affects up to 70% of liver transplant recipients and is the second most common complication after rejection and graft dysfunction. Identified risk factors for infection include: previous transplantation; type of biliary anastomosis; transfusion requirements at surgery; surgical complications; duration of operation; duration of postoperative ventilation; serological status of donor and recipient; steroid use and serotherapy for rejection; and pre- and post-transplant antibiotic usage. The majority of symptomatic infections are bacterial and relate to surgery (intra-abdominal, biliary and wound infections), ventilation and intravenous cannulae. Cytomegalovirus infections occur in 45-100% of recipients but are asymptomatic in the majority. Fungal infections are mostly due to Candida albicans but infections due to Aspergillus spp. occur in approximately 6% and carry a high mortality. There are very few prospective comparative trials of antimicrobial prophylaxis in this patient population. The management of these patients needs to be based on such studies.
高达70%的肝移植受者会发生感染，感染是仅次于排斥反应和移植物功能障碍的第二大常见并发症。已确定的感染风险因素包括：既往移植史；胆管吻合方式；手术中的输血需求；手术并发症；手术时间；术后通气时间；供体和受体的血清学状态；类固醇使用及抗排斥血清疗法；移植前后抗生素的使用。大多数有症状的感染为细菌感染，与手术（腹腔内、胆管和伤口感染）、通气及静脉插管有关。45%至100%的受者会发生巨细胞病毒感染，但大多数情况下无症状。真菌感染大多由白色念珠菌引起，但曲霉菌属感染约占6%，且死亡率很高。在这一患者群体中，很少有关于抗菌预防的前瞻性对照试验。对这些患者的管理需要基于此类研究。
