供者来源性感染对肝移植受者的影响

The effect of donor-derived infections on liver transplantation recipents

目的探讨供者来源性感染对肝移植受者的影响。方法回顾性分析2017年1月-2017年11月首都医科大学附属北京友谊医院的47例公民逝世后器官捐献的肝脏移植患者的临床资料,根据器官保存液的培养结果分为阳性组和阴性组,结合肝移植受者术后痰、引流液的培养结果与预后,分析肝移植受者术后发生的感染与供者来源病原体的相关性。结果 47例受者中,阳性组16例,阴性组31例,共有19例患者术后发生感染,痰培养阳性9例,引流液培养阳性12例。阳性组中患者术后痰培养阳性6例,引流液结果阳性8例,其中6例患者术后引流液培养的病原菌与其器官保存液病原菌一致;阴性组中患者术后痰培养阳性3例,引流液结果阳性4例。抗感染治疗后,阳性组受者中1例因多器官功能衰竭死亡,其余患者的培养结果转阴,生存良好;阴性组所有受者培养结果转阴,全部生存良好。结论供者来源性感染对肝移植术后受者发生感染及预后有一定影响。

Objective To investigate the effect of donor-derived infections on the recipients with liver transplantation（LT）. Methods We conducted a retrospective analysis on the clinical data among 47 donation after cardiac death（DCD）donors from January 2017 to November 2017 in Beijing Friendship Hospital, Capital Medical University. The patients were divided into positive and negative groups according to the culture result of perfusion fluid. Then these culture results of perfusion fluids were analyzed with the culture results of sputum and drainage fluid after LT, in order to show the correlation between patient infection and donor-derived pathogen. Results In 47 patients,sixteen were in positive group,and thirty-one patients in negative group. Nineteen patients suffered from infections after LT,including nine patients with positive results in sputum culture, and twelve patients with positive results in drainage fluid culture. In positive group,sputum cultures of six patients were positive, and results of drainage fluid culture were positive in eight patients. In six patients, pathogens were same in drainage fluids and perfusion fluids. In negative group, three patients were positive insputum culture, four patients were positive in drainage fluid culture. Finally, there was one patient died of multiple organ failure in positive group. Other recipients in positive group survived well after anti-infective treatments. The recipients in negative group were all survived well. Conclusion Donor-derived infections had an effect on the infection and prognosis of recipients after LT.