Bacterial translocation in clinical intestinal transplantation

Luca Cicalese, Pierpaolo Sileri, Michael Green, Kareem Abu-Elmagd, Samuel Kocoshis, Jorge Reyes

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Background. Bacterial translocation (BT) has been suggested to be responsible for the high incidence of infections occurring after small bowel transplantation (SBTx). Bacterial overgrowth, alteration of the mucosal barrier function as a consequence of preservation injury or acute rejection (AR), and potent immunosuppression are all associated with BT. The aim of this study was to evaluate and quantify the correlation of BT with these events. Methods. Fifty pediatric SBTx recipients on tacrolimus and prednisone immunosuppression were analyzed. Blood, stool, and liver biopsies and peritoneal fluid were cultured (circa 4000 total specimens) when infection was clinically suspected or as part of follow-up. BT episodes were considered when microorganisms were found simultaneously in blood or liver biopsy and stool. Results. BT (average of 2.0 episodes/patient) was evident in 44% of patients and was most frequently caused by Enterococcus, Staphylococcus, Enterobacter, and Klebsiella. The presence of a colon allograft was associated with a higher rate of BT (75% vs. 33.3%). Furthermore, the transplantation procedure (colon vs. no colon) affected the rate of BT: SBTx=40% vs. 25%, combined liver and SBTx=100% vs. 30%, multivisceral transplantation =25% vs. 50%. AR was associated with 39% of BT episodes. BT followed AR in 9.6% of the cases. In 5.2% of the cases, positive blood cultures without stool confirmation of the bacteria were seen. Prolonged cold ischemia time (CIT) affected BT rate significantly (CIT>9 hr 76% vs. CIT<9 hr 20.8%). Conclusions. This study shows that 1) a substantial percentage of, but not all, BT is associated with AR, 2) the presence of a colon allograft increases the risk for BT, and 3) a long CIT is associated with a high incidence of BT after SBTx.

Original languageEnglish (US)
Pages (from-to)1414-1417
Number of pages4
JournalTransplantation
Volume71
Issue number10
StatePublished - May 27 2001
Externally publishedYes

Fingerprint

Bacterial Translocation
Transplantation
Cold Ischemia
Colon
Immunosuppression
Allografts
Liver
Biopsy
Enterobacter
Klebsiella
Ascitic Fluid
Incidence
Enterococcus
Tacrolimus
Prednisone
Infection
Staphylococcus

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Cicalese, L., Sileri, P., Green, M., Abu-Elmagd, K., Kocoshis, S., & Reyes, J. (2001). Bacterial translocation in clinical intestinal transplantation. Transplantation, 71(10), 1414-1417.

Bacterial translocation in clinical intestinal transplantation. / Cicalese, Luca; Sileri, Pierpaolo; Green, Michael; Abu-Elmagd, Kareem; Kocoshis, Samuel; Reyes, Jorge.

In: Transplantation, Vol. 71, No. 10, 27.05.2001, p. 1414-1417.

Research output: Contribution to journalArticle

Cicalese, L, Sileri, P, Green, M, Abu-Elmagd, K, Kocoshis, S & Reyes, J 2001, 'Bacterial translocation in clinical intestinal transplantation', Transplantation, vol. 71, no. 10, pp. 1414-1417.
Cicalese L, Sileri P, Green M, Abu-Elmagd K, Kocoshis S, Reyes J. Bacterial translocation in clinical intestinal transplantation. Transplantation. 2001 May 27;71(10):1414-1417.
Cicalese, Luca ; Sileri, Pierpaolo ; Green, Michael ; Abu-Elmagd, Kareem ; Kocoshis, Samuel ; Reyes, Jorge. / Bacterial translocation in clinical intestinal transplantation. In: Transplantation. 2001 ; Vol. 71, No. 10. pp. 1414-1417.
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