Early and late onset Clostridium difficile-associated colitis following liver transplantation

Jeffrey B. Albright, Hugo Bonatti, Julio C Mendez, David Kramer, John Stauffer, Ronald Hinder, Jaime A. Michel, Rolland Dickson, Chris Hughes, Justin H Nguyen, Heidi Chua, Walter Hellinger

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Clostridium difficile colitis (CDC) remains a serious and common complication after liver transplantation (LT). Four hundred and sixty-seven consecutive LTs in 402 individuals were performed between 1998 and 2001 at our center. Standard immunosuppression consisted of tacrolimus, mycophenolate, and steroids. CD toxins A and B were detected by using a rapid immunoassay or enzyme immunoassay. CDC was diagnosed in 32 patients (5-1999 days post-LT), with 93.8% (30/32) of patients developing CDC during the first year post-LT; three individuals had CDC more than 3 years post-LT, one of which also had early CDC. All patients presented with abdominal pain and watery diarrhea. Patients who developed CDC within 1-year post-LT were significantly more likely to have a hemorrhagic, biliary, or infectious complication. Patients who developed CDC within 28 days post-LT had a significantly higher model end-stage liver disease score. Treatment consisted of fluid and electrolyte replacement and metronidazole and no patients developed toxic megacolon, required colonic resection, or died from CDC. CDC represents a potentially severe complication following LT. Most cases occur early post-LT. Development of a hemorrhagic, biliary, or infectious complication is associated with the development of CDC.

Original languageEnglish (US)
Pages (from-to)856-866
Number of pages11
JournalTransplant International
Volume20
Issue number10
DOIs
StatePublished - Oct 2007

Fingerprint

Clostridium difficile
Colitis
Liver Transplantation
Toxic Megacolon
End Stage Liver Disease
Metronidazole
Tacrolimus
Immunoenzyme Techniques
Immunoassay
Immunosuppression
Abdominal Pain
Electrolytes
Diarrhea
Steroids

Keywords

  • Clostridium difficile
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Early and late onset Clostridium difficile-associated colitis following liver transplantation. / Albright, Jeffrey B.; Bonatti, Hugo; Mendez, Julio C; Kramer, David; Stauffer, John; Hinder, Ronald; Michel, Jaime A.; Dickson, Rolland; Hughes, Chris; Nguyen, Justin H; Chua, Heidi; Hellinger, Walter.

In: Transplant International, Vol. 20, No. 10, 10.2007, p. 856-866.

Research output: Contribution to journalArticle

Albright, JB, Bonatti, H, Mendez, JC, Kramer, D, Stauffer, J, Hinder, R, Michel, JA, Dickson, R, Hughes, C, Nguyen, JH, Chua, H & Hellinger, W 2007, 'Early and late onset Clostridium difficile-associated colitis following liver transplantation', Transplant International, vol. 20, no. 10, pp. 856-866. https://doi.org/10.1111/j.1432-2277.2007.00530.x
Albright, Jeffrey B. ; Bonatti, Hugo ; Mendez, Julio C ; Kramer, David ; Stauffer, John ; Hinder, Ronald ; Michel, Jaime A. ; Dickson, Rolland ; Hughes, Chris ; Nguyen, Justin H ; Chua, Heidi ; Hellinger, Walter. / Early and late onset Clostridium difficile-associated colitis following liver transplantation. In: Transplant International. 2007 ; Vol. 20, No. 10. pp. 856-866.
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