Factors in association with sepsis after liver transplantation: the Hungarian experience.

Sepsis is the major cause of patient death after orthotopic liver transplantation (OLT). To identify risk factors for sepsis, we analyzed all 199 primary OLTs performed between 1995 and 2004. Patients were divided into 2 groups according to whether they experienced sepsis after liver transplantation. Recipient, perioperative factors, and complications were subjected to univariate analyses. Statistically significant factors were exposed to multivariate analyses: Cox regression and Hosmer-Lemeshow test. Sepsis occurred in 45 (23%) patients. Recipient Child-Pugh score, preoperative broad spectrum antibiotic (meropenem) prophylaxis, intraoperative red blood cell transfusion, starch infusion, postoperative bleeding, hepatic artery thrombosis, and biliary leakage/necrosis were independent risk factors for sepsis. Our results agree with the international experience. A high amount of starch infusion and an extended use of broad spectrum antibiotics for prophylaxis adverse experiences in our center and have been removed from the protocol.

[The use of teicoplanin for Gram-positive infections in patients with kidney transplantation]. / Teicoplanin alkalmazása vesetranszplantáltak gram-pozitív infekcióiban.

Teicoplanin was used for the treatment of multiresistant Gram-positive-Staphylococcus aureus, coagulase negative Staphylococcus and Enterococcus-infections in 15 cases of kidney transplantations. The motive of the application was the once per day dosage and the spare of the transplanted kidney. Nosocomial infections were the most common. Clinical and microbiological diagnosis was the criteria in order to begin the 5-21 days treatment. These patients which were infected with Gram positive bacteria, teicoplanin was also effective in methicillin-resistant cases. In some mixed infections, after several courses of antibiotics, teicoplanin even if combined with other antibiotics could not prevent fatal sepsis.