Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes
dc.contributor.author | Chiang, Diana | |
dc.contributor.author | Dingle, Tanis C. | |
dc.contributor.author | Belga, Sara | |
dc.contributor.author | Kabbani, Dima | |
dc.contributor.author | Bhanji, Rahima A. | |
dc.contributor.author | Walter, Jens | |
dc.contributor.author | Abraldes, Juan G. | |
dc.contributor.author | Cervera, Carlos | |
dc.date.accessioned | 2022-03-11T11:22:56Z | |
dc.date.available | 2022-03-11T11:22:56Z | |
dc.date.issued | 2022-03-05 | |
dc.date.updated | 2022-03-10T15:22:39Z | |
dc.description.abstract | 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. | en |
dc.description.status | Peer reviewed | en |
dc.description.version | Accepted Version | en |
dc.format.mimetype | application/pdf | en |
dc.identifier.citation | 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 | en |
dc.identifier.doi | 10.1111/tid.13821 | en |
dc.identifier.eissn | 1399-3062 | |
dc.identifier.issn | 1398-2273 | |
dc.identifier.journaltitle | Transplant Infectious Disease | en |
dc.identifier.uri | https://hdl.handle.net/10468/12892 | |
dc.language.iso | en | en |
dc.publisher | John 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.subject | Vancomycin-resistant enterococci | en |
dc.subject | Liver transplantation | en |
dc.subject | Post-transplant outcomes | en |
dc.subject | Microbiota | en |
dc.subject | VRE colonization | en |
dc.subject | Acute kidney injury | en |
dc.subject | MELD | en |
dc.subject | Mortality | en |
dc.title | Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes | en |
dc.type | Article (peer-reviewed) | en |
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