Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study

Abstract Decompensated cirrhotic patients experience severely increased intestinal permeability and bacterial translocation. Thus, autologous blood salvaged during deceased donor liver transplantation (DDLT) may be contaminated with enteric bacteria. We aimed to evaluate bacterial contamination of a...

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Main Authors: Doyeon Kim, Sangbin Han, Ju Dong Yang, Ji-Hye Kwon, Gyu-Sung Choi, Jong Man Kim, Yoon Joo Chung, Chisong Chung, Justin S. Ko, Mi Sook Gwak, Jae-Won Joh, Gaab Soo Kim
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Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-76476-w
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author Doyeon Kim
Sangbin Han
Ju Dong Yang
Ji-Hye Kwon
Gyu-Sung Choi
Jong Man Kim
Yoon Joo Chung
Chisong Chung
Justin S. Ko
Mi Sook Gwak
Jae-Won Joh
Gaab Soo Kim
author_facet Doyeon Kim
Sangbin Han
Ju Dong Yang
Ji-Hye Kwon
Gyu-Sung Choi
Jong Man Kim
Yoon Joo Chung
Chisong Chung
Justin S. Ko
Mi Sook Gwak
Jae-Won Joh
Gaab Soo Kim
author_sort Doyeon Kim
collection DOAJ
description Abstract Decompensated cirrhotic patients experience severely increased intestinal permeability and bacterial translocation. Thus, autologous blood salvaged during deceased donor liver transplantation (DDLT) may be contaminated with enteric bacteria. We aimed to evaluate bacterial contamination of autologous blood salvaged during DDLT and its association with post-transplant bacteremia. In 30 patients undergoing DDLT, bacterial culture was performed in salvaged autologous blood samples: one before graft reperfusion (non-leukoreduced) and two after graft reperfusion (non-leukoreduced and leukoreduced). The primary outcome was bacterial contamination of salvaged autologous blood. Seven of 30 patients (23.3%) were positive for bacteria (3 enteric/4 non-enteric) before graft reperfusion while 11 patients (36.7%) were positive (5 enteric/6 non-enteric) after graft reperfusion. Six of 7 patients who were positive for bacteria before graft reperfusion were positive after graft reperfusion with the same bacteria. Only 4 of 11 contaminated blood samples were converted to negative after leukoreduction. Post-transplant bacteremia risk was insignificantly greater in patients who received autologous blood with bacteria than in patients without bacteria (30.0% vs. 5.0%, P = 0.06). We found contamination of salvaged autologous blood with enteric bacteria throughout DDLT and incomplete performance of leukoreduction, indicating high bacterial load. The potential association between contaminated autotransfusion and post-transplant bacteremia warrants further validation in a larger prospective study. Clinical trial notation: This study was registered at the Clinical Research Information Service (CRiS; https://cris.nih.go.kr ; No. KCT0007223; principal registration investigator: Sangbin Han, date of registration: April 25, 2022).
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spelling doaj-art-ec4f207c3c00412681ddf19680ba6b012025-08-20T02:50:00ZengNature PortfolioScientific Reports2045-23222024-11-0114111010.1038/s41598-024-76476-wBacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational studyDoyeon Kim0Sangbin Han1Ju Dong Yang2Ji-Hye Kwon3Gyu-Sung Choi4Jong Man Kim5Yoon Joo Chung6Chisong Chung7Justin S. Ko8Mi Sook Gwak9Jae-Won Joh10Gaab Soo Kim11Department of Anesthesiology and pain medicine, CHA Bundang Medical Center, CHA University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineKarsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Cedars-Sinai Medical CenterDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and pain medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Decompensated cirrhotic patients experience severely increased intestinal permeability and bacterial translocation. Thus, autologous blood salvaged during deceased donor liver transplantation (DDLT) may be contaminated with enteric bacteria. We aimed to evaluate bacterial contamination of autologous blood salvaged during DDLT and its association with post-transplant bacteremia. In 30 patients undergoing DDLT, bacterial culture was performed in salvaged autologous blood samples: one before graft reperfusion (non-leukoreduced) and two after graft reperfusion (non-leukoreduced and leukoreduced). The primary outcome was bacterial contamination of salvaged autologous blood. Seven of 30 patients (23.3%) were positive for bacteria (3 enteric/4 non-enteric) before graft reperfusion while 11 patients (36.7%) were positive (5 enteric/6 non-enteric) after graft reperfusion. Six of 7 patients who were positive for bacteria before graft reperfusion were positive after graft reperfusion with the same bacteria. Only 4 of 11 contaminated blood samples were converted to negative after leukoreduction. Post-transplant bacteremia risk was insignificantly greater in patients who received autologous blood with bacteria than in patients without bacteria (30.0% vs. 5.0%, P = 0.06). We found contamination of salvaged autologous blood with enteric bacteria throughout DDLT and incomplete performance of leukoreduction, indicating high bacterial load. The potential association between contaminated autotransfusion and post-transplant bacteremia warrants further validation in a larger prospective study. Clinical trial notation: This study was registered at the Clinical Research Information Service (CRiS; https://cris.nih.go.kr ; No. KCT0007223; principal registration investigator: Sangbin Han, date of registration: April 25, 2022).https://doi.org/10.1038/s41598-024-76476-wAutologous transfusionAutotransfusionBacterial translocationCell salvageCell saverCirrhosis
spellingShingle Doyeon Kim
Sangbin Han
Ju Dong Yang
Ji-Hye Kwon
Gyu-Sung Choi
Jong Man Kim
Yoon Joo Chung
Chisong Chung
Justin S. Ko
Mi Sook Gwak
Jae-Won Joh
Gaab Soo Kim
Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
Scientific Reports
Autologous transfusion
Autotransfusion
Bacterial translocation
Cell salvage
Cell saver
Cirrhosis
title Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
title_full Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
title_fullStr Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
title_full_unstemmed Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
title_short Bacterial contamination of autologous blood salvaged during deceased donor liver transplantation: a prospective observational study
title_sort bacterial contamination of autologous blood salvaged during deceased donor liver transplantation a prospective observational study
topic Autologous transfusion
Autotransfusion
Bacterial translocation
Cell salvage
Cell saver
Cirrhosis
url https://doi.org/10.1038/s41598-024-76476-w
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