Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant
Abstract Background Bacterial translocation (BT) has been proposed as a trigger for stimulation of the immune system with consequent hemodynamic alteration in patients with liver cirrhosis. However, no information is available regarding its hemodynamic and coagulation consequences during liver trans...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12871-018-0507-7 |
| _version_ | 1818244058405928960 |
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| author | Heba A. Moharem Fawzia Aboul Fetouh Hamed M. Darwish Doaa Ghaith Mohamed Elayashy Amr Hussein Riham Elsayed Mohammad M. Khalil Amr Abdelaal Mahmoud ElMeteini Ahmed Mukhtar |
| author_facet | Heba A. Moharem Fawzia Aboul Fetouh Hamed M. Darwish Doaa Ghaith Mohamed Elayashy Amr Hussein Riham Elsayed Mohammad M. Khalil Amr Abdelaal Mahmoud ElMeteini Ahmed Mukhtar |
| author_sort | Heba A. Moharem |
| collection | DOAJ |
| description | Abstract Background Bacterial translocation (BT) has been proposed as a trigger for stimulation of the immune system with consequent hemodynamic alteration in patients with liver cirrhosis. However, no information is available regarding its hemodynamic and coagulation consequences during liver transplantation. Methods We screened 30 consecutive adult patients undergoing living-donor liver transplant for the presence of BT. Bacterial DNA, Anti factor Xa (aFXa), thromboelastometry, tumor necrosis factor-α TNF-α, and interleukin-17 (IL-17) values were measured in sera before induction of anesthesia. Systemic hemodynamic data were recorded throughout the procedures. Results Bacterial DNA was detected in 10 patients (33%) (bactDNA(+)). Demographic, clinical, and hemodynamic data were similar in patients with presence or absence of bacterial DNA. BactDNA(+) patients showed significantly higher circulating values of TNF-α and IL-17, and had significantly higher clotting times and clot formation times as well as significantly lower alpha angle and maximal clot firmness than bactDNA(−) patients, P < 0.05. We found no statistically significant difference in aFXa between the groups, P = 0.4. Additionally, 4 patients in each group needed vasopressor agents, P = 0.2. And, the amount of transfused blood and blood products used were similar between both groups. Conclusion Bacterial translocation was found in one-third of patients at the time of transplantation and was largely associated with increased markers of inflammation along with decreased activity of coagulation factors. Trial registration Trial Registration Number: NCT03230214. (Retrospective registered). Initial registration date was 20/7/2017. |
| first_indexed | 2024-12-12T14:10:59Z |
| format | Article |
| id | doaj.art-8d5ce48c313b406c9b5985569ba2de0e |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-12T14:10:59Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-8d5ce48c313b406c9b5985569ba2de0e2022-12-22T00:22:06ZengBMCBMC Anesthesiology1471-22532018-04-011811710.1186/s12871-018-0507-7Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplantHeba A. Moharem0Fawzia Aboul Fetouh1Hamed M. Darwish2Doaa Ghaith3Mohamed Elayashy4Amr Hussein5Riham Elsayed6Mohammad M. Khalil7Amr Abdelaal8Mahmoud ElMeteini9Ahmed Mukhtar10Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Alexandria UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Alexandria UniversityDepartment of clinical and chemical pathology, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo UniversityDepartment of clinical and chemical pathology, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Alexandria UniversityDepartment of surgery, Ainshams UniversityDepartment of surgery, Ainshams UniversityDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo UniversityAbstract Background Bacterial translocation (BT) has been proposed as a trigger for stimulation of the immune system with consequent hemodynamic alteration in patients with liver cirrhosis. However, no information is available regarding its hemodynamic and coagulation consequences during liver transplantation. Methods We screened 30 consecutive adult patients undergoing living-donor liver transplant for the presence of BT. Bacterial DNA, Anti factor Xa (aFXa), thromboelastometry, tumor necrosis factor-α TNF-α, and interleukin-17 (IL-17) values were measured in sera before induction of anesthesia. Systemic hemodynamic data were recorded throughout the procedures. Results Bacterial DNA was detected in 10 patients (33%) (bactDNA(+)). Demographic, clinical, and hemodynamic data were similar in patients with presence or absence of bacterial DNA. BactDNA(+) patients showed significantly higher circulating values of TNF-α and IL-17, and had significantly higher clotting times and clot formation times as well as significantly lower alpha angle and maximal clot firmness than bactDNA(−) patients, P < 0.05. We found no statistically significant difference in aFXa between the groups, P = 0.4. Additionally, 4 patients in each group needed vasopressor agents, P = 0.2. And, the amount of transfused blood and blood products used were similar between both groups. Conclusion Bacterial translocation was found in one-third of patients at the time of transplantation and was largely associated with increased markers of inflammation along with decreased activity of coagulation factors. Trial registration Trial Registration Number: NCT03230214. (Retrospective registered). Initial registration date was 20/7/2017.http://link.springer.com/article/10.1186/s12871-018-0507-7Bacterial translocationLiver transplantationBacterial DNACoagulation factors |
| spellingShingle | Heba A. Moharem Fawzia Aboul Fetouh Hamed M. Darwish Doaa Ghaith Mohamed Elayashy Amr Hussein Riham Elsayed Mohammad M. Khalil Amr Abdelaal Mahmoud ElMeteini Ahmed Mukhtar Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant BMC Anesthesiology Bacterial translocation Liver transplantation Bacterial DNA Coagulation factors |
| title | Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant |
| title_full | Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant |
| title_fullStr | Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant |
| title_full_unstemmed | Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant |
| title_short | Effects of bacterial translocation on hemodynamic and coagulation parameters during living-donor liver transplant |
| title_sort | effects of bacterial translocation on hemodynamic and coagulation parameters during living donor liver transplant |
| topic | Bacterial translocation Liver transplantation Bacterial DNA Coagulation factors |
| url | http://link.springer.com/article/10.1186/s12871-018-0507-7 |
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