Identifying Risk of Sepsis Early: A Way to Improve Outcomes for Patients with Early Allograft Dysfunction After Liver Transplantation?
General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
Meeting: 2017 American Transplant Congress
Abstract number: B217
Keywords: Graft function, Infection, Liver transplantation, Risk factors
Session Information
Session Name: Poster Session B: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Early Allograft Dysfunction (EAD) after Liver Transplantation (LT) is associated with increased morbidity and mortality, which is strongly associated with sepsis/septic shock. Aim of this analysis was to identify clinical risk factors for sepsis in the setting of EAD after LT.
We retrospectively analyzed all adult liver transplantations from January 2007 to June 2012. Recipient data, donor data and treatment data were analyzed and correlated with occurrence of sepsis after LT and patient/graft survival by univariable/multivariable logistic regression and cox proportional hazards.
564 patients underwent primary LT. 30-days and 12-months patient survival was 81.7% and 68.3%, respectively. Patients developing EAD had significantly reduced 1-year graft and patient survival (49%, 56.8 %) compared to patients with regular graft function after LT (76.8%, 77%). Sepsis occurred in 35.1% of patients with EAD compared to 22.8% of patients with no EAD. Multivariable analysis of all available data showed that the preoperative labMELD, pretransplant mechanical ventilation, occurrence of EAD, surgical reintervention after LT and bile leakage after LT are independent predictors for sepsis after LT. A point scoring system was created: A score of 0 was assigned as no-sepsis risk, 1-4 low sepsis risk, 5-7 median sepsis risk, 8-10 high sepsis risk. This score reached statistical significance (p = 0.001) by cross validation. The risk to develop sepsis after LT for scores 0, 1-4, 5-7 and 8-10 were 10.9%, 24.2%, 46.2% and 61.9%, respectively.
EAD is already a validated risk factor for inferior patient and graft survival after LT. Our scoring enables early risk assessment of life-threatening infections in these patients, to start an adequate treatment without any delay, which is the backbone for improved survival in sepsis and septic shock.
CITATION INFORMATION: Hoyer D, Benko T, Sotiropoulos G, Paul A, Saner F. Identifying Risk of Sepsis Early: A Way to Improve Outcomes for Patients with Early Allograft Dysfunction After Liver Transplantation? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hoyer D, Benko T, Sotiropoulos G, Paul A, Saner F. Identifying Risk of Sepsis Early: A Way to Improve Outcomes for Patients with Early Allograft Dysfunction After Liver Transplantation? [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/identifying-risk-of-sepsis-early-a-way-to-improve-outcomes-for-patients-with-early-allograft-dysfunction-after-liver-transplantation/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress