Endotoxemia is common following abdominal organ transplantation and is associated with reperfusion and rejection

Abstract

Objective. Patients undergoing orthotopic liver transplantation (OLT) and multi-visceral transplantation (MVT) may have an increased incidence of endotoxemia due to translocation of endotoxin from the intestine, in combination with impaired hepatic clearance. We sought to evaluate the presence of endotoxemia in the perioperative period, using the Endotoxin Activity Assay™ (EAA) to understand the association of endotoxin activity (EA) with clinical course and outcome. Material and methods. In this prospective observational pilot study we measured EA in 40 patients undergoing OLT or MVT during the perioperative period. As a control, the EAA was performed on 10 healthy adult volunteers. We analyzed the relationships between EA and graft function, episodes of rejection, infection and outcome. Results. Mean EA in the control group was 0.21±0.05 u (range 0.16–0.27 u). For patients, baseline pre-transplant EA was significantly greater than that in controls at 0.50±0.17 u (range 0.10–0.80 u) (p=0.001) and further...