J Helenius-Hietala1, F Aberg, J H Meurman, H Isoniemi. 1. Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
Abstract
OBJECTIVE: Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life-threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post-transplant infectious complications. SUBJECTS AND METHODS: Medical and dental data came from hospital records and infection data from the Finnish LT registry. The follow-up was until February 2011. Of 51 patients (LT during 2000-2006), 16 had and 35 did not have dental treatment pretransplant. RESULTS: Univariate Cox regression analysis demonstrated a 2.46-fold (95% CI 1.06-5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre- and post-transplant factors, the corresponding infection risk increased, respectively, to 8.17-fold (95% CI 2.19-30.6) and 8.54-fold (95% CI 1.82-40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation. CONCLUSION: High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.
OBJECTIVE:Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life-threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post-transplant infectious complications. SUBJECTS AND METHODS: Medical and dental data came from hospital records and infection data from the Finnish LT registry. The follow-up was until February 2011. Of 51 patients (LT during 2000-2006), 16 had and 35 did not have dental treatment pretransplant. RESULTS: Univariate Cox regression analysis demonstrated a 2.46-fold (95% CI 1.06-5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre- and post-transplant factors, the corresponding infection risk increased, respectively, to 8.17-fold (95% CI 2.19-30.6) and 8.54-fold (95% CI 1.82-40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation. CONCLUSION: High risk of infections was noticed in acute liver failurepatients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.
Authors: Karita M Nylund; Jukka H Meurman; Anna Maria Heikkinen; Jussi O Furuholm; Fernanda Ortiz; Hellevi M Ruokonen Journal: Clin Oral Investig Date: 2017-04-20 Impact factor: 3.573
Authors: Birgitta Söder; Leif C Andersson; Jukka H Meurman; Per-Östen Söder Journal: Philos Trans R Soc Lond B Biol Sci Date: 2015-02-05 Impact factor: 6.237
Authors: Dirk Ziebolz; Gerhard Schmalz; Anne Kauffels; Florian Widmer; Katja Widmer; Jan E Slotta; Rainer F Mausberg; Otto Kollmar Journal: Clin Oral Investig Date: 2016-04-13 Impact factor: 3.573
Authors: Anne Kauffels; Gerhard Schmalz; Otto Kollmar; Jan E Slotta; Michael Weig; Uwe Groß; Oliver Bader; Dirk Ziebolz Journal: Int Dent J Date: 2017-03-10 Impact factor: 2.607