The impact of perioperative synbiotics treatment in living-donor liver transplantation after induction of early enteral nutrition.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2024-08-19 DOI:10.1007/s00595-024-02918-7

Shohei Yoshiya, Shinji Itoh, Takeo Toshima, Yuki Bekki, Takuma Izumi, Norifumi Iseda, Yuriko Tsutsui, Katsuya Toshida, Yuki Nakayama, Takuma Ishikawa, Tomoharu Yoshizumi

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Abstract

Purpose: Infectious complications, particularly post-transplant sepsis, have a critical impact on postoperative outcomes. This study examined the effects of perioperative synbiotic treatment on postoperative outcomes in patients receiving early enteral nutrition.

Methods: We reviewed 210 living-donor liver transplantation procedures and retrospectively analyzed the postoperative outcomes with and without perioperative synbiotic treatment (live lactic acid bacteria, bifidobacteria, and oligosaccharides) 5 days before and after living-donor liver transplantation.

Results: The synbiotic group (n = 34) had significantly fewer male donors (38.2% vs. 61.9%, p = 0.011) and a higher proportion of ABO-incompatible grafts (52.9% vs. 25.6%, p = 0.021) than the non-synbiotic group (n = 176). The incidence of sepsis was significantly lower in the synbiotic group than in the non-synbiotic group (0% vs. 7.4%, p = 0.029), with a lower incidence rate of sepsis due to bacteremia with intestinal bacteria (0% vs. 4.6%, p = 0.089). There were no significant differences in the proportions of acute rejection, small-for-size graft syndrome, or postoperative liver function between the two groups. Furthermore, there was no significant difference in the graft survival rates after LDLT between two groups. (p = 0.24).

Conclusion: Perioperative synbiotic treatment prevents post-transplant sepsis, even with early enteral nutrition.

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早期肠内营养诱导后，活体肝移植围手术期合成益生菌治疗的影响。

目的：感染并发症，尤其是移植后败血症，对术后预后有着至关重要的影响。本研究探讨了围手术期合生元治疗对接受早期肠内营养患者术后效果的影响：我们回顾了 210 例活体肝移植手术，并回顾性分析了活体肝移植手术前后 5 天使用和未使用围手术期益生菌（活乳酸菌、双歧杆菌和低聚糖）治疗的术后效果：结果：与非同步生物组（n = 176）相比，同步生物组（n = 34）男性供体明显较少（38.2% vs. 61.9%，p = 0.011），ABO不相容移植物的比例也较高（52.9% vs. 25.6%，p = 0.021）。合成生化组的败血症发生率明显低于非合成生化组（0% vs. 7.4%，p = 0.029），其中肠道细菌引起的败血症发生率较低（0% vs. 4.6%，p = 0.089）。两组急性排斥反应、小尺寸移植物综合征或术后肝功能的比例无明显差异。此外，两组 LDLT 术后的移植物存活率也无明显差异（P = 0.24）。(P=0.24）：结论：围手术期合生元治疗可预防移植后败血症，即使早期肠内营养也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.