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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2020; 26(45): 7191-7203
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7191
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7191
High mortality associated with gram-negative bacterial bloodstream infection in liver transplant recipients undergoing immunosuppression reduction
Fang Chen, Xiao-Yun Pang, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
Chuan Shen, Long-Zhi Han, Xiao-Song Chen, Jian-Jun Zhang, Qiang Xia, Yong-Bing Qian, Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
Yu-Xiao Deng, Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
Author contributions: Chen F and Qian YB designed the study; Pang XY, Shen C, Han LZ, Chen XS, Zhang JJ, and Deng YX participated in the acquisition, analysis, and interpretation of the data; Chen F, Qian YB, and Deng YX drafted the initial manuscript; Zhang JJ, Xia Q, and Qian YB revised the article critically for important intellectual content.
Supported by the National Key R&D Precision Medicine Program , No. 2017YFC0908100 ; and Shanghai Key Clinical Specialty Grant , No. Shslczdzk05801 .
Institutional review board statement: The study was reviewed and approved by Renji Hospital, Shanghai Jiaotong University School of Medicine Review Board (Approval No. KY2019-160).
Informed consent statement: The informed consent was waived by the ethics committee.
Conflict-of-interest statement: All authors declare no conflicts of interest regarding the conduct and publication of this study.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Bing Qian, MD, Associate Professor, Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai 200127, China. qianyb79@hotmail.com
Received: September 17, 2020
Peer-review started: September 17, 2020
First decision: October 17, 2020
Revised: October 30, 2020
Accepted: November 9, 2020
Article in press: November 9, 2020
Published online: December 7, 2020
Peer-review started: September 17, 2020
First decision: October 17, 2020
Revised: October 30, 2020
Accepted: November 9, 2020
Article in press: November 9, 2020
Published online: December 7, 2020
Core Tip
Core Tip: Bacterial infections are the most common infectious complication after liver transplantation (LT). Immunosuppression (IS) reduction is usually needed in case of bacterial infections in LT recipients. However, we do not know exactly the incidence of IS reduction during bloodstream infection after LT and its effect on patient outcome. This single-center analysis summarized the IS reduction data in 70 LT recipients. We found IS reduction is more frequently associated with Gram-negative bacterial infection than Gram-positive bacterial infection in LT recipients. Complete withdrawal of IS should be done cautiously due to increased risk of mortality.