Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes

dc.check.date2023-03-05
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorChiang, Diana
dc.contributor.authorDingle, Tanis C.
dc.contributor.authorBelga, Sara
dc.contributor.authorKabbani, Dima
dc.contributor.authorBhanji, Rahima A.
dc.contributor.authorWalter, Jens
dc.contributor.authorAbraldes, Juan G.
dc.contributor.authorCervera, Carlos
dc.date.accessioned2022-03-11T11:22:56Z
dc.date.available2022-03-11T11:22:56Z
dc.date.issued2022-03-05
dc.date.updated2022-03-10T15:22:39Z
dc.description.abstractBackground: 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.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationChiang, 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.13821en
dc.identifier.doi10.1111/tid.13821en
dc.identifier.eissn1399-3062
dc.identifier.issn1398-2273
dc.identifier.journaltitleTransplant Infectious Diseaseen
dc.identifier.urihttps://hdl.handle.net/10468/12892
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.rights© 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.en
dc.subjectVancomycin-resistant enterococcien
dc.subjectLiver transplantationen
dc.subjectPost-transplant outcomesen
dc.subjectMicrobiotaen
dc.subjectVRE colonizationen
dc.subjectAcute kidney injuryen
dc.subjectMELDen
dc.subjectMortalityen
dc.titleAssociation between gut colonization of vancomycin-resistant enterococci and liver transplant outcomesen
dc.typeArticle (peer-reviewed)en
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