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The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Surgical Site Infection After Intestine Transplantation: Risk Factors and Outcomes.

Mayyadah H Alabdely1, Jessica Lum1, Blanca E Gonzalez2

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Summary

Surgical site infections (SSIs) are common after intestine transplants, often caused by multidrug-resistant organisms. These infections significantly increase the risk of death or allograft failure, especially within the first year post-transplant.

Keywords:
graft lossintestine transplantoutcomerisk factorssurgical site infections

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Area of Science:

  • Transplantation Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Infections pose a significant threat to intestine transplant recipients.
  • Surgical site infections (SSIs) are a common but poorly understood complication in this patient group.

Purpose of the Study:

  • To investigate the incidence, risk factors, and outcomes of SSIs in intestine transplant recipients.
  • To define the epidemiology and impact of SSIs in this vulnerable population.

Main Methods:

  • A retrospective cohort study of 152 intestine transplant recipients from 2008-2022.
  • Analysis of SSIs within 30 days post-transplantation using CDC/NHSN criteria.
  • Multivariable Cox regression to identify risk factors and the association of SSI with mortality or allograft failure.

Main Results:

  • Over a third (36.2%) of recipients developed 30-day SSIs, predominantly organ/space infections (90.9%).
  • Common pathogens included Enterococcus faecium and Candida species; multidrug-resistant organisms were prevalent (68.6%).
  • Liver-inclusive transplantation, high comorbidity index, and gastrointestinal leak were risk factors for SSI. SSI was linked to increased risk of death or allograft failure (HR 1.71), particularly within the first year (HR 3.30).

Conclusions:

  • SSIs are frequent, severe complications in intestine transplantation, often involving multidrug-resistant organisms.
  • Liver-intestine and multivisceral transplant recipients face the highest risk.
  • SSIs are associated with poor long-term outcomes, emphasizing the need for risk mitigation strategies.