Učestalost postoperativnih infekcija nakon transplantacije jetre u ranom postoperativnom razdoblju do 30 dana

master's thesis

• Title (english): Frequency of infections in the early postoperative period of 30 days following liver transplantation
• Author: Vana Stojić
• Mentor: Stipislav Jadrijević (mentor)
• Committee member: Danko Mikulić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Stipislav Jadrijević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Transplantacija jetre je metoda liječenja krajnjih stadija jetrenih bolesti bilo u akutnom ili kroničnom stanju. Rezervirana je za krajnje stadije bolesti zbog veće potražnje nego dostupnosti presadaka, ali i zbog kompleksnosti samog zahvata. Komplikacije se mogu pojaviti intraoperativno, ali i u ranom i kasnijem postoperativnom razdoblju. Najveći udio komplikacija u ranom postoperativnom razdoblju od 30 dana čine disfunkcija grafta, odbacivanje i infekcije. Kasnije su komplikacije uglavnom povezane s lijekovima induciranom imunosupresijom. Transplantacije bez posljedice infekcije su vrlo rijetke. Infekcije se javljaju u oko 80% transplantacija i povećavaju morbiditet i mortalitet ovih pacijenata. Dijele se u infekcije ranog, srednjeg i kasnog posttransplantacijskog razdoblja.
Najčešće se javljaju u ranom posttransplantacijskom razdoblju kada im je uzrok uglavnom bakterijski, uključujući nozokomijalne infekcije. Oportunističke infekcije su jedna od važnih infektivnih komplikacija kasnijeg postoperativnog razdoblja. Rastući problem je antimikrobna rezistencija kauzalnih agensa uzrokovana iracionalnom uporabom antibiotika. Klinička slika varira od blage, samolimitirajuće upale sve do teže kliničke slike i sepse koja je glavni uzrok smrti ovih pacijenata. Prevencija uključuje aseptičnu tehniku zahvata, adekvatnu imunosupresivnu terapiju nakon transplantacije i profilaktičku uporabu antimikrobnih lijekova temeljenu na optimalnom doziranju i odabiru sukladno epidemiološkoj slici. Daljnje studije o infektivnim komplikacijama transplantacijskog postupka su nužne da bi se postigao što bolji ishod ovih pacijenata.

Abstract (english)

Liver transplantation is a method of treatment of end stage liver diseases in either acute or chronic state. Due to the lack of supply of organs relative to demand, as well as the complexity of the procedure, it is reserved for end stage liver diseases. Complications can occur intraoperatively, but also in the early and late postoperative periods. The main complications in the early, 30-day, postoperative period include graft dysfunction, rejection and infections. Later complications are mainly linked to drug-induced induced immunosuppression. Transplantations without infection are very rare; infections occur in about 80% of transplantations and they increase the morbidity and mortality of these patients. They are divided into infections of early, intermediate and late posttransplantation period. Early posttransplantation infections are the most common and the cause is usually bacterial, including nosocomial infections. Opportunistic infections remain one of the important infectious complications of the later postoperative period. An increasing problem is antimicrobial resistance of causal agents caused by inappropriate use of antibiotics. Clinical presentation varies from mild, self-limiting inflammation to more severe manifestations, such as sepsis, which is the leading cause of death in patients. Prevention includes aseptic techniques, adequate post-procedural imunosuppressive therapy and prophylactic use of antimicrobial drugs based on optimal dosing and selection according to the epidemiological situation. Further studies of infection following transplant procedure are necessary to provide a better outcome for these patients.

• Keywords: infekcija; transplantacija jetre; rano postoperativno razdoblje
• Keywords (english): infection; liver transplantation; early postoperative period
• Language: croatian
• URN:NBN: urn:nbn:hr:105:073988
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-05-12 08:01:52