Probiotics before LT help to prevent infection post-transplant
Researchers found that giving probiotics and prebiotics to a patient before liver transplantation successfully reduced the rate of infection post-transplant, according to published findings in Clinical Gastroenterology and Hepatology.
“Among patients who have received liver transplants, infections increase morbidity and mortality and prolong hospital stays,” the researchers wrote. “Probiotics are believed to prevent bacterial translocation by stabilizing the intestinal barrier and stimulating proliferation of the intestinal epithelium, mucus secretion and motility.”
Researchers conducted a meta-analysis using data collected from four controlled studies found in the PubMed and EMBASE databases. Altogether, 246 patients were included in the systematic review and meta-analysis. Of these patients, 123 received probiotics and 123 acted as controls. The researchers evaluated the effects of prebiotics and probiotics on infections in patients who underwent liver transplantation.
The overall infection rate was 7% among patients that received probiotics compared with 35% among the controls ([relative risk] RR = 0.21; 95% CI, 0.11-0.41). The number needed to treat to prevent one infection was 3.6, according to the research.
Subgroup analyses showed that 2% of patients in the probiotic groups developed a urinary tract infection compared with 16% of controls (RR = 0.14; 95% CI, 0.04-0.47) and 2% of patients in the probiotic groups developed an intra-abdominal infection compared with 11% of controls (RR = 0.27; 95% CI, 0.09-0.78).
Patients who received probiotics had shorter hospital stays, shorter stays in the intensive care unit and shorter duration of antibiotic use (P < .001 for all).
“Our findings show that the use of a combination of probiotics and prebiotics before or on the day of surgery decreases the postliver transplant infection rate and could shorten the hospital stay, ICU stay and the duration of antibiotic use,” the researchers concluded. “A well-powered, randomized, clinical trial is needed to better determine the true benefit of the use of probiotics and prebiotics. Future studies also need to examine both types of strains and doses to better define our findings.” – by Melinda Stevens
Disclosures: The researchers report no relevant financial disclosures.