Abstract
A detailed dental examination and surgical treatment of oral septic foci are recommended in patients awaiting liver transplantation (LT). This standard procedure is based on the idea that patients with untreated dental disease may have an increased risk for post-LT infections. Aim of this study was to evaluate the influence of dental diseases and pre-LT treatment on the infection rates in patients after LT. Patients and methods: From April 2003 until November 2009, 216 patients (154m, 51±11yrs) underwent LT in our centre. The underlying causes were alcohol (45.4%), alcohol + viral hepatitis (6.5%), viral hepatitis (15.3%), biliary tract diseases (14.8%) and others. The patients were divided into 4 groups. Group 1: patients with bad dental status and following dental surgery; group 2: patients with bad dental status without dental treatment; group 3: patients with good dental status; group 4: no pre-LT dental examination available. The medical data were assessed on patients' records and analyzed retrospectively. Results: Mean follow-up after LT was 43±28 months. 58 patients (27%) belonged to group 1, 43 patients (20%) to group 2, 54 patients (25%) to group 3 and 61 patients (28%) to group 4. Bacterial infections, mostly cholangitis and pneumonia, were observed in 49% of all transplanted patients 0-72 months (mean 12 months) after LT. In 46% enterococcus spp. was the most detectable pathogen in the blood and different tissues. However, there was no significant difference in the frequency of bacterial infections and the pathogen spectrum in the 4 different groups. 68 patients died 0-63 months after LT, thereby 25 patients due to bacterial sepsis. Furthermore, significantly (p< 0.001) more patients with alcohol toxic liver cirrhosis suffered from a bad dental status in comparison to patients with other liver diseases. Conclusions: Our data suggest, that there is no significant effect of pre-LT dental status on the outcome of liver transplant patients. Standard dental restoration obviating prophylactic teeth extraction seems sufficient for patients undergoing LT.
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