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Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes
Dingle, Tanis C.
Bhanji, Rahima A.
Abraldes, Juan G.
John Wiley & Sons, Inc.
Background: Vancomycin-resistant enterococci (VRE) colonization is common in liver transplant recipients and has been associated with worse post-transplant outcomes. Methods: We conducted a retrospective cohort study at the University of Alberta Hospital including patients who underwent a liver transplant between September 2014 and December 2017. Results: Of 343 patients, 68 (19.8%) had pre-transplant VRE colonization and 27 (27/275, 9.8%) acquired VRE post-transplant, 67% were males and the median age was 56.5 years. VRE colonized patients at baseline had higher MELD scores and required longer post-transplant hospitalization. VRE colonization was associated with increased risk of early acute kidney injury (AKI) (64% vs 52%, p = 0. 044), clinically significant bacterial/fungal infection (29% vs 17%, p = 0. 012) and invasive VRE infection (5% vs 1%, p = 0. 017). Mortality at 2-years was 13% in VRE-colonized versus 7% in non-colonized (p = 0.085). On multivariate analysis, VRE colonization increased the risk of post-transplant AKI (HR 1.504, 95% CI: 1.077-2.100, p = 0.017) and clinically significant bacterial or fungal infection at 6 months (HR 2.038, 95%CI: 1.222-3.399, p = 0.006), and was associated with non-significant trend towards increased risk of mortality at 2-years post-transplant (HR 1.974 95% CI 0.890-4.378; p = 0.094). Conclusions: VRE colonization in liver transplant patients is associated with increased risk of early AKI, clinically significant infections, and a trend towards increased mortality at 2-years.
Vancomycin-resistant enterococci , Liver transplantation , Post-transplant outcomes , Microbiota , VRE colonization , Acute kidney injury , MELD , Mortality
Chiang, D., Dingle, T. C., Belga, S., Kabbani, D., Bhanji, R. A., Walter, J., Abraldes, J. G. and Cervera, C. (2022) 'Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes', Transplant Infectious Disease. doi: 10.1111/tid.13821
© 2022, John Wiley & Sons Ltd. This is the accepted version of the following item: Chiang, D., Dingle, T. C., Belga, S., Kabbani, D., Bhanji, R. A., Walter, J., Abraldes, J. G. and Cervera, C. (2022) 'Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes', Transplant Infectious Disease, doi: 10.1111/tid.13821, which has been published in final form at: https://doi.org/10.1111/tid.13821. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.