Increased infection risk postliver transplant without pretransplant dental treatment
Version of Record online: 6 AUG 2012
© 2012 John Wiley & Sons A/S
Volume 19, Issue 3, pages 271–278, April 2013
How to Cite
Oral Diseases (2012) doi: 10.1111/j.1601-0825.2012.01974.x
- Issue online: 21 MAR 2013
- Version of Record online: 6 AUG 2012
- Accepted manuscript online: 14 JUL 2012 10:45AM EST
- Manuscript Accepted: 9 JUL 2012
- Manuscript Revised: 25 JUN 2012
- Manuscript Received: 28 MAY 2012
- EVO. Grant Number: T1020Y0011
- Helsinki University Central Hospital
- acute liver failure;
- dental infections;
- infectious complications;
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.
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.
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.