Increased infection risk postliver transplant without pretransplant dental treatment
Correspondence: Dr. Jaana Helenius-Hietala, Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, PO Box 41, Helsinki FI-00014, Finland. Tel: +358 40 724 7275, Fax: +358 9 191 27286, E-mail: email@example.com
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.