Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 14, 2007; 13(14): 2072-2076
Published online Apr 14, 2007. doi: 10.3748/wjg.v13.i14.2072
Clostridium difficile-associated diarrhea after living donor liver transplantation
Masao Hashimoto, Yasuhiko Sugawara, Sumihito Tamura, Junichi Kaneko, Yuichi Matsui, Junichi Togashi, Masatoshi Makuuchi
Masao Hashimoto, Yasuhiko Sugawara, Sumihito Tamura, Junichi Kaneko, Yuichi Matsui, Junichi Togashi, Masatoshi Makuuchi, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Author contributions: All authors contributed equally to the work.
Supported by a Grant-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan and Grants-in-aid for Research on HIV/AIDS, a multicenter pilot clinical study to compare the safety and efficacy of a steroid and steroid free immunosuppression protocol with monoclonal anti-IL2R antibody in HCV positive living donor liver transplantation and Research on Measures for Intractable Diseases from the Ministry of Health, Labor and Welfare of Japan
Correspondence to: Yasuhiko Sugawara, MD, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yasusuga-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-56843989
Received: November 10, 2006
Revised: March 23, 2007
Accepted: March 30, 2007
Published online: April 14, 2007
Abstract

AIM: To assess the incidence and analyze the risk factors for Clostridium difficile-associated diarrhea (CDAD) after living donor liver transplantation (LDLT) in adult.

METHODS: The micobiological data and medical records of 242 adult recipients that underwent LDLT at the Tokyo University Hospital were analyzed retrospectively. The independent risk factors for postoperative CDAD were identified.

RESULTS: Postoperative CDAD occurred in 11 (5%) patients. Median onset of CDAD was postoperative d 19 (range, 5-54). In the multivariate analyses, male gender (odds ratio, 4.56) and serum creatinine (≥ 1.5 mg/dL, odds ratio, 16.0) independently predicted postoperative CDAD.

CONCLUSION: CDAD should be considered in the differential diagnosis of patients with postoperative diarrhea after LDLT.

Keywords: Living donor liver transplantation, Clostridium difficile, Diarrhea