ArticleJournal of clinical and experimental hepatology
Outcomes of Living Donor Liver Transplantation in Recipients Colonized With Carbapenem-Resistant Enterobacterales.
Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Gut colonization with multidrug-resistant organisms in hospitalized patients with gastrointestinal illness: A single-centre, cross-sectional study.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Drug-resistant bacterial infections in end-stage liver disease: immune imbalance and intervention advances.Frontiers in immunology · 2026Review
- Carbapenem-resistant Enterobacteriaceae Colonization and Impact on Outcomes in Cirrhosis.Journal of clinical and experimental hepatologyArticle
- Silent Carriers, Severe Consequences: The Hidden Threat of Carbapenem-Resistant Enterobacteriaceae Colonization in Liver Transplantation.Journal of clinical and experimental hepatologyArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pretransplant colonization with carbapenem-resistant Enterobacterales (CRE) is associated with poorer post-liver transplantation (LT) outcomes. We aimed to analyze the incidence and risk factors for CRE colonization in adult living-donor LT recipients from January 2019 to September 2022 and its impact on post-LT outcomes. Methods: Relevant perioperative parameters including bacteremia within one month post LT were recorded. Rectal swabs were used for screening living-donor liver transplantation (LDLT) recipients for CRE colonization and divided into CRE-positive (CRE-POS) and CRE-negative (CRE-NEG) groups. Results: A total of 499 patients were included in study, and 163 (32.6%) were CRE colonized and received pre-emptive probiotics. Median Model for End-Stage Liver Disease score (odds ratio [OR]: 1.05 [95% confidence interval {CI}: 1.02-1.08]) and preoperative acute kidney injury (AKI) (OR: 1.95 [95% CI: 1.28-2.98]) were independently associated with preoperative CRE colonization. CRE-POS patients had higher intraoperative packed red blood cell transfusion (5 [3, 7] vs 3 [1, 6]) along with a higher incidence of post-LT bacteremia (19.6% vs 9.8%, Conclusion: One-third of patients presenting for LDLT are already colonized with CRE. Preoperative CRE colonization is a risk factor for postoperative Enterobacterales septicemia but not with CRE bacteremia. Post-liver transplant CRE bacteremia has a significantly higher mortality. Active pre-LT surveillance for CRE, along with the use of targeted pre-emptive therapy as probiotics and a low threshold for discretionary use of appropriate guideline-based antibiotic therapy based on CRE colonization status, in the event of sepsis, can help improve outcomes in this cohort of LDLT recipients.
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