The impact of perioperative synbiotics treatment in living-donor liver transplantation after induction of early enteral nutrition

• Published in: Surgery today (Tokyo, Japan) Japan), 2024-08
• Main Authors: Yoshiya, Shohei, Itoh, Shinji, Toshima, Takeo, Bekki, Yuki, Izumi, Takuma, Iseda, Norifumi, Tsutsui, Yuriko, Toshida, Katsuya, Nakayama, Yuki, Ishikawa, Takuma, Yoshizumi, Tomoharu
• Format: Article
• Language: English
• ISSN: 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02918-7

Infectious complications, particularly post-transplant sepsis, have a critical impact on postoperative outcomes. This study examined the effects of perioperative synbiotic treatment on postoperative outcomes in patients receiving early enteral nutrition. We reviewed 210 living-donor liver transplantation procedures and retrospectively analyzed the postoperative outcomes with and without perioperative synbiotic treatment (live lactic acid bacteria, bifidobacteria, and oligosaccharides) 5 days before and after living-donor liver transplantation. The synbiotic group (n = 34) had significantly fewer male donors (38.2% vs. 61.9%, p = 0.011) and a higher proportion of ABO-incompatible grafts (52.9% vs. 25.6%, p = 0.021) than the non-synbiotic group (n = 176). The incidence of sepsis was significantly lower in the synbiotic group than in the non-synbiotic group (0% vs. 7.4%, p = 0.029), with a lower incidence rate of sepsis due to bacteremia with intestinal bacteria (0% vs. 4.6%, p = 0.089). There were no significant differences in the proportions of acute rejection, small-for-size graft syndrome, or postoperative liver function between the two groups. Furthermore, there was no significant difference in the graft survival rates after LDLT between two groups. (p = 0.24). Perioperative synbiotic treatment prevents post-transplant sepsis, even with early enteral nutrition.