In:
Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 29, No. 12 ( 2022-12), p. 1264-1273
Abstract:
Following liver transplantation (LT), bacterial infections occur in over 70% of recipients leading to significant morbidity and mortality. While synbiotics have been reported to decrease infectious complications in various surgical procedures, the evidence of their benefits following LT remains limited. Methods In this 18‐month double‐blinded, investigator‐initiated, placebo‐controlled trial, 100 recipients of live donor liver transplant (LDLT) were randomized to receive either the synbiotic drug Prowel® (Prepro arm) or a placebo, starting 2 days pretransplant and continued for 2 weeks. The primary endpoint was culture‐proven bacterial infection in blood, urine or drain fluid within 30 days. Secondary endpoints were hospital stay, noninfectious complications, antibiotic usage and 30‐day mortality. Results Overall infectious complications were significantly lower in the Prepro arm in comparison to the Placebo arm (44% vs 22%, P = .019, OR 0.359; CI: 0.150–0.858). Blood stream infections were significantly less in the study arm (21.7% vs 53.3%, P = .020, OR 0.243; CI: 0.072–0.826), whereas urinary tract and intra‐abdominal infections were similar. Length of hospital stay, noninfectious complications, deviation from protocol antibiotics and 30‐day mortality were comparable. Conclusion Synbiotics administered for 2 weeks following LDLT significantly reduced overall and blood stream infectious complications in the early postoperative period. However, there was no difference in hospital stay, noninfectious complications, antibiotic usage and mortality. Clinical Trial Registry of India registration number – CTRI/2017/09/009869.
Type of Medium:
Online Resource
ISSN:
1868-6974
,
1868-6982
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2536390-6
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