Probiotic use in preventing postoperative infection in liver transplant patients

Background: Although liver transplantation has been widely practised, post-operative bacterial infectionis still a frequent complication which contributed to an increased risk of fatality. There were studies onpreoperative use of probiotics for liver transplant patients and acquired reduction in postoperative sepsis andwound infection, but the relevant clinical experience with pre- and probiotics is still limited.Objectives: This study is to assess fibre and probiotic use aimed at preventing bacterial sepsis and woundcomplications in patients undergoing liver transplantation.Study methods: There were a total of sixty-seven adult patients scheduled for liver transplantation wereincluded in a public teaching hospital. From January to December 2011, 34 continuous patients followingliver transplantation were put on fibre + probiotics. In retrospectively, from January to December 2010, 33continuous patients were collected as a control group and they were only received fibre post operation. Theincidence of bacterial infections was compared in patients receiving either fibre and lactobacillus or fibreonly. Statistical analysis was performed using SPSS 15. The t test, fisher’s and chi- square test was used tocompare discrete variables.Results: In summary, in the analysis of 67 liver transplant recipients, 8.8% group A patients developedinfections compared to 30.3% group B patients. The difference between groups A and B was statisticallysignificant in both cases. In addition, the duration of antibiotic therapy was significantly shorter in thelactobacillus-group. Wound infection was the most frequent infections and enterococci the most frequentlyisolated bacteria. Fibre and lactobacilli were well tolerated in most cases. The operating time, amountof intra- and post-operatively transfused units of blood, fresh frozen plasma and albumin did not differsignificantly between the groups.Conclusions: Combined fibre and probiotics could lower the incidence of bacterial infections and shortenthe duration of antibiotic therapy following liver transplantation in comparison to conventional nutrition. Incontrast to antibiotics, it is relatively cheap and does not cause resistant strains or serious side effects.