Increased infection risk postliver transplant without pretransplant dental treatment
Identifieur interne : 000029 ( Istex/Corpus ); précédent : 000028; suivant : 000030Increased infection risk postliver transplant without pretransplant dental treatment
Auteurs : J. Helenius-Hietala ; F. Berg ; Jh Meurman ; H. IsoniemiSource :
- Oral Diseases [ 1354-523X ] ; 2013-04.
English descriptors
- KwdEn :
- Acute liver failure, Acute liver failure patients, Albumin dialysis, Amanita phalloides mushroom intoxication, Autoimmune hepatitis, Bacterial infection, Candida, Candida albicans, Chronic kidney disease, Corresponding infection risk, Critical evaluation, Cyclosporine, Data acquisition, Dental, Dental data, Dental examination, Dental infections, Dental procedures, Dental screening, Dental treatment, Different time points, Early indicators, Encephalopathy grade, Evaluation process, Finland, Fungal infections, Good dentition, Good dentitions, Helsinki, Helsinki university, Herpes zoster, Immunosuppression, Immunosuppressive medication, Incidence rates, Infection, Infection episodes, Infection risk, Infection types, Infectious complications, Liver disease, Liver rupture, Liver transpl, Liver transplant patient, Liver transplantation, Medical condition, Methylprednisolone, Molecular adsorbent recirculating system, Months cyclosporine trough level tacrolimus trough level methylprednisolone dose, Months infections, Multivariate, Multivariate analysis, Oral candidosis, Oral cavity, Oral diseases, Oral diseases importance, Oral health, Oral origin, Oral pathol, Oral surg, Organ transplant patients, Other infections, Patient characteristics, Periodontal, Positive blood cultures, Preterm birth, Pretransplant, Pretransplant dialysis, Pretransplant factors, Radiol endod, Regression analysis, Screening, Sepsis, Sepsis cases, Serum levels, Standard deviation, Study groups, Tacrolimus, Tooth extractions, Tract infection, Transplant, Transplant proc, Transplant recipients, Transplantation, Trough, Trough level, Trough levels.
- Teeft :
- Acute liver failure, Acute liver failure patients, Albumin dialysis, Amanita phalloides mushroom intoxication, Autoimmune hepatitis, Bacterial infection, Candida, Candida albicans, Chronic kidney disease, Corresponding infection risk, Critical evaluation, Cyclosporine, Data acquisition, Dental, Dental data, Dental examination, Dental infections, Dental procedures, Dental screening, Dental treatment, Different time points, Early indicators, Encephalopathy grade, Evaluation process, Finland, Fungal infections, Good dentition, Good dentitions, Helsinki, Helsinki university, Herpes zoster, Immunosuppression, Immunosuppressive medication, Incidence rates, Infection, Infection episodes, Infection risk, Infection types, Infectious complications, Liver disease, Liver rupture, Liver transpl, Liver transplant patient, Liver transplantation, Medical condition, Methylprednisolone, Molecular adsorbent recirculating system, Months cyclosporine trough level tacrolimus trough level methylprednisolone dose, Months infections, Multivariate, Multivariate analysis, Oral candidosis, Oral cavity, Oral diseases, Oral diseases importance, Oral health, Oral origin, Oral pathol, Oral surg, Organ transplant patients, Other infections, Patient characteristics, Periodontal, Positive blood cultures, Preterm birth, Pretransplant, Pretransplant dialysis, Pretransplant factors, Radiol endod, Regression analysis, Screening, Sepsis, Sepsis cases, Serum levels, Standard deviation, Study groups, Tacrolimus, Tooth extractions, Tract infection, Transplant, Transplant proc, Transplant recipients, Transplantation, Trough, Trough level, Trough levels.
Abstract
Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.
Url:
DOI: 10.1111/j.1601-0825.2012.01974.x
Links to Exploration step
ISTEX:00768C2B6C5E7197B22D37A63E023EC88FDC3234Le document en format XML
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Berg</name><affiliation><mods:affiliation>Transplantation and Liver Surgery Clinic, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Meurman, Jh" sort="Meurman, Jh" uniqKey="Meurman J" first="Jh" last="Meurman">Jh Meurman</name><affiliation><mods:affiliation>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Isoniemi, H" sort="Isoniemi, H" uniqKey="Isoniemi H" first="H" last="Isoniemi">H. 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Helenius-Hietala</name><affiliation><mods:affiliation>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jaana.s.helenius@helsinki.fi</mods:affiliation></affiliation></author><author><name sortKey=" Berg, F" sort=" Berg, F" uniqKey=" Berg F" first="F" last=" Berg">F. 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mushroom intoxication</term><term>Autoimmune hepatitis</term><term>Bacterial infection</term><term>Candida</term><term>Candida albicans</term><term>Chronic kidney disease</term><term>Corresponding infection risk</term><term>Critical evaluation</term><term>Cyclosporine</term><term>Data acquisition</term><term>Dental</term><term>Dental data</term><term>Dental examination</term><term>Dental infections</term><term>Dental procedures</term><term>Dental screening</term><term>Dental treatment</term><term>Different time points</term><term>Early indicators</term><term>Encephalopathy grade</term><term>Evaluation process</term><term>Finland</term><term>Fungal infections</term><term>Good dentition</term><term>Good dentitions</term><term>Helsinki</term><term>Helsinki university</term><term>Herpes zoster</term><term>Immunosuppression</term><term>Immunosuppressive medication</term><term>Incidence rates</term><term>Infection</term><term>Infection episodes</term><term>Infection risk</term><term>Infection types</term><term>Infectious complications</term><term>Liver disease</term><term>Liver rupture</term><term>Liver transpl</term><term>Liver transplant patient</term><term>Liver transplantation</term><term>Medical condition</term><term>Methylprednisolone</term><term>Molecular adsorbent recirculating system</term><term>Months cyclosporine trough level tacrolimus trough level methylprednisolone dose</term><term>Months infections</term><term>Multivariate</term><term>Multivariate analysis</term><term>Oral candidosis</term><term>Oral cavity</term><term>Oral diseases</term><term>Oral diseases importance</term><term>Oral health</term><term>Oral origin</term><term>Oral pathol</term><term>Oral surg</term><term>Organ transplant patients</term><term>Other infections</term><term>Patient characteristics</term><term>Periodontal</term><term>Positive blood cultures</term><term>Preterm birth</term><term>Pretransplant</term><term>Pretransplant dialysis</term><term>Pretransplant factors</term><term>Radiol endod</term><term>Regression analysis</term><term>Screening</term><term>Sepsis</term><term>Sepsis cases</term><term>Serum levels</term><term>Standard deviation</term><term>Study groups</term><term>Tacrolimus</term><term>Tooth extractions</term><term>Tract infection</term><term>Transplant</term><term>Transplant proc</term><term>Transplant recipients</term><term>Transplantation</term><term>Trough</term><term>Trough level</term><term>Trough levels</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Acute liver failure</term><term>Acute liver failure patients</term><term>Albumin dialysis</term><term>Amanita phalloides mushroom intoxication</term><term>Autoimmune hepatitis</term><term>Bacterial infection</term><term>Candida</term><term>Candida albicans</term><term>Chronic kidney disease</term><term>Corresponding infection risk</term><term>Critical evaluation</term><term>Cyclosporine</term><term>Data acquisition</term><term>Dental</term><term>Dental data</term><term>Dental examination</term><term>Dental infections</term><term>Dental procedures</term><term>Dental screening</term><term>Dental treatment</term><term>Different time points</term><term>Early indicators</term><term>Encephalopathy grade</term><term>Evaluation process</term><term>Finland</term><term>Fungal infections</term><term>Good dentition</term><term>Good dentitions</term><term>Helsinki</term><term>Helsinki university</term><term>Herpes zoster</term><term>Immunosuppression</term><term>Immunosuppressive medication</term><term>Incidence rates</term><term>Infection</term><term>Infection episodes</term><term>Infection risk</term><term>Infection types</term><term>Infectious complications</term><term>Liver disease</term><term>Liver rupture</term><term>Liver transpl</term><term>Liver transplant patient</term><term>Liver transplantation</term><term>Medical condition</term><term>Methylprednisolone</term><term>Molecular adsorbent recirculating system</term><term>Months cyclosporine trough level tacrolimus trough level methylprednisolone dose</term><term>Months infections</term><term>Multivariate</term><term>Multivariate analysis</term><term>Oral candidosis</term><term>Oral cavity</term><term>Oral diseases</term><term>Oral diseases importance</term><term>Oral health</term><term>Oral origin</term><term>Oral pathol</term><term>Oral surg</term><term>Organ transplant patients</term><term>Other infections</term><term>Patient characteristics</term><term>Periodontal</term><term>Positive blood cultures</term><term>Preterm birth</term><term>Pretransplant</term><term>Pretransplant dialysis</term><term>Pretransplant factors</term><term>Radiol endod</term><term>Regression analysis</term><term>Screening</term><term>Sepsis</term><term>Sepsis cases</term><term>Serum levels</term><term>Standard deviation</term><term>Study groups</term><term>Tacrolimus</term><term>Tooth extractions</term><term>Tract infection</term><term>Transplant</term><term>Transplant proc</term><term>Transplant recipients</term><term>Transplantation</term><term>Trough</term><term>Trough level</term><term>Trough levels</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>pretransplant</json:string><json:string>transplantation</json:string><json:string>dental screening</json:string><json:string>dental treatment</json:string><json:string>helsinki</json:string><json:string>multivariate</json:string><json:string>immunosuppression</json:string><json:string>candida</json:string><json:string>dental examination</json:string><json:string>infection risk</json:string><json:string>liver transplantation</json:string><json:string>methylprednisolone</json:string><json:string>tacrolimus</json:string><json:string>cyclosporine</json:string><json:string>sepsis</json:string><json:string>periodontal</json:string><json:string>transplant</json:string><json:string>medical 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endod</json:string><json:string>finland</json:string><json:string>screening</json:string><json:string>trough</json:string></teeft></keywords><author><json:item><name>J Helenius‐Hietala</name><affiliations><json:string>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</json:string><json:string>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</json:string><json:string>E-mail: jaana.s.helenius@helsinki.fi</json:string></affiliations></json:item><json:item><name>F Åberg</name><affiliations><json:string>Transplantation and Liver Surgery Clinic, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item><json:item><name>JH Meurman</name><affiliations><json:string>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</json:string><json:string>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item><json:item><name>H Isoniemi</name><affiliations><json:string>Transplantation and Liver Surgery Clinic, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>acute liver failure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dental infections</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>infectious complications</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>outcome</value></json:item></subject><articleId><json:string>ODI1974</json:string></articleId><arkIstex>ark:/67375/WNG-TX5454JQ-K</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.</abstract><qualityIndicators><refBibsNative>true</refBibsNative><abstractWordCount>43</abstractWordCount><abstractCharCount>359</abstractCharCount><keywordCount>4</keywordCount><score>6.945</score><pdfWordCount>4429</pdfWordCount><pdfCharCount>30932</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>8</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize></qualityIndicators><title>Increased infection risk postliver transplant without pretransplant dental treatment</title><pmid><json:string>22882454</json:string></pmid><genre><json:string>article</json:string></genre><host><title>Oral Diseases</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1601-0825</json:string></doi><issn><json:string>1354-523X</json:string></issn><eissn><json:string>1601-0825</json:string></eissn><publisherId><json:string>ODI</json:string></publisherId><volume>19</volume><issue>3</issue><pages><first>271</first><last>278</last><total>8</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Original Article</value></json:item></subject></host><namedEntities><unitex><date><json:string>2011</json:string><json:string>2000</json:string><json:string>2012-07-21</json:string></date><geogName></geogName><orgName><json:string>SPSS Inc., Chicago</json:string><json:string>Helsinki University</json:string><json:string>Department of Oral and Maxillofacial Diseases</json:string><json:string>HUCH Research Committee</json:string><json:string>Helsinki University Central Hospital, Helsinki, Finland</json:string><json:string>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, PO Box</json:string><json:string>Helsinki University Central Hospital, Helsinki, Finland OBJECTIVE</json:string><json:string>American Heart Association</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Age</json:string><json:string>Jaana Helenius-Hietala</json:string><json:string>Infections</json:string></persName><placeName><json:string>Finland</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Fisher et al, 2010</json:string><json:string>Ioannidou et al, 2006</json:string><json:string>Sautner et al, 1995</json:string><json:string>Helenius-Hietala et al, 2012</json:string><json:string>Le Moine et al, 1994</json:string><json:string>February 2011</json:string><json:string>Saner et al, 2008</json:string><json:string>Bascones-Martínez et al, 2009</json:string><json:string>Meyer et al, 1999</json:string><json:string>Helenius-Hietala et al</json:string><json:string>Bjøro et al, 2001</json:string><json:string>Fishman, 2007</json:string><json:string>Tilg et al, 1992</json:string><json:string>del Pozo, 2008</json:string><json:string>Offenbacher et al, 2008</json:string><json:string>Talwani et al, 2011</json:string><json:string>Scannapieco et al, 2010</json:string><json:string>Melkos et al, 2005</json:string><json:string>Yoshida et al, 1993</json:string><json:string>Douglas et al, 1998</json:string><json:string>Heimonen et al, 2009</json:string><json:string>Åberg et al, 2011</json:string><json:string>Ohashi et al, 2008</json:string><json:string>HeleniusHietala et al, 2012</json:string><json:string>Little and Rhodus, 1992</json:string><json:string>Rustemeyer and Bremerich, 2007</json:string><json:string>Guggenheimer et al, 2003, 2007</json:string><json:string>Kantola et al, 2009</json:string><json:string>Koivusalo et al, 2009</json:string><json:string>Pizzo et al, 2010</json:string><json:string>Kita et al, 1996</json:string><json:string>Rautemaa and Ramage, 2011</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-TX5454JQ-K</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - dentistry, oral surgery & medicine</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dentistry</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Dentistry</json:string><json:string>3 - General Dentistry</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Otorhinolaryngology</json:string></scopus></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1111/j.1601-0825.2012.01974.x</json:string></doi><id>00768C2B6C5E7197B22D37A63E023EC88FDC3234</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/00768C2B6C5E7197B22D37A63E023EC88FDC3234/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/00768C2B6C5E7197B22D37A63E023EC88FDC3234/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/00768C2B6C5E7197B22D37A63E023EC88FDC3234/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Increased infection risk postliver transplant without pretransplant dental treatment</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Publishing Ltd</publisher><availability><licence>© 2012 John Wiley & Sons A/S</licence></availability><date type="published" when="2013-04"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Increased infection risk postliver transplant without pretransplant dental treatment</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">J</forename><surname>Helenius‐Hietala</surname></persName><affiliation><orgName>Department of Oral Infectious Diseases</orgName><orgName>Institute of Dentistry</orgName><orgName>University of Helsinki</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation><affiliation><orgName>Department of Oral and Maxillofacial Diseases</orgName><orgName>Helsinki University Central Hospital</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation><affiliation>Correspondence: Dr. Jaana Helenius‐Hietala, Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, PO Box 41, Helsinki FI‐00014, Finland. Tel: +358 40 724 7275, Fax: +358 9 191 27286, E‐mail: jaana.s.helenius@helsinki.fi</affiliation></author><author xml:id="author-0001"><persName><forename type="first">F</forename><surname>Åberg</surname></persName><affiliation><orgName>Transplantation and Liver Surgery Clinic</orgName><orgName>Helsinki University Central Hospital</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">JH</forename><surname>Meurman</surname></persName><affiliation><orgName>Department of Oral Infectious Diseases</orgName><orgName>Institute of Dentistry</orgName><orgName>University of Helsinki</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation><affiliation><orgName>Department of Oral and Maxillofacial Diseases</orgName><orgName>Helsinki University Central Hospital</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">H</forename><surname>Isoniemi</surname></persName><affiliation><orgName>Transplantation and Liver Surgery Clinic</orgName><orgName>Helsinki University Central Hospital</orgName><address><settlement type="city">Helsinki</settlement><country key="FI">Finland</country></address></affiliation></author><idno type="istex">00768C2B6C5E7197B22D37A63E023EC88FDC3234</idno><idno type="ark">ark:/67375/WNG-TX5454JQ-K</idno><idno type="DOI">10.1111/j.1601-0825.2012.01974.x</idno><idno type="unit">ODI1974</idno><idno type="toTypesetVersion">file:ODI.ODI1974.pdf</idno></analytic><monogr><title level="j" type="main">Oral Diseases</title><title level="j" type="alt">ORAL DISEASES</title><idno type="pISSN">1354-523X</idno><idno type="eISSN">1601-0825</idno><idno type="book-DOI">10.1111/(ISSN)1601-0825</idno><idno type="book-part-DOI">10.1111/odi.2013.19.issue-3</idno><idno type="product">ODI</idno><imprint><biblScope unit="vol">19</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="271">271</biblScope><biblScope unit="page" to="278">278</biblScope><biblScope unit="page-count">8</biblScope><date type="published" when="2013-04"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main" xml:id="odi1974-abs-0001">
Objective
<p>Infections cause considerable morbidity after liver transplantation (<hi rend="fc">LT</hi>). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.</p>
Subjects and methods
<p>Medical and dental data came from hospital records and infection data from the <hi rend="fc">F</hi>innish <hi rend="fc">LT</hi> registry. The follow‐up was until <hi rend="fc">F</hi>ebruary 2011. Of 51 patients (<hi rend="fc">LT</hi> during 2000–2006), 16 had and 35 did not have dental treatment pretransplant.</p>
Results
<p>Univariate <hi rend="fc">C</hi>ox regression analysis demonstrated a 2.46‐fold (95% <hi rend="fc">CI</hi> 1.06–5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre‐ and post‐transplant factors, the corresponding infection risk increased, respectively, to 8.17‐fold (95% <hi rend="fc">CI</hi> 2.19–30.6) and 8.54‐fold (95% <hi rend="fc">CI</hi> 1.82–40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation.</p>
Conclusion
<p>High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.</p></abstract><textClass><keywords><term xml:id="odi1974-kwd-0001">acute liver failure</term><term xml:id="odi1974-kwd-0002">dental infections</term><term xml:id="odi1974-kwd-0003">infectious complications</term><term xml:id="odi1974-kwd-0004">outcome</term></keywords><keywords rend="articleCategory"><term>Original Article</term></keywords><keywords rend="tocHeading1"><term>Original Articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/00768C2B6C5E7197B22D37A63E023EC88FDC3234/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="odi1974" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1601-0825</doi><issn type="print">1354-523X</issn><issn type="electronic">1601-0825</issn><idGroup><id type="product" value="ODI"></id></idGroup><titleGroup><title sort="ORAL DISEASES" type="main">Oral Diseases</title><title type="short">Oral Dis</title></titleGroup></publicationMeta><publicationMeta level="part" position="04103"><doi origin="wiley">10.1111/odi.2013.19.issue-3</doi><copyright ownership="publisher">Copyright © 2013 John Wiley and Sons A/S</copyright><numberingGroup><numbering type="journalVolume" number="19">19</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2013-04">April 2013</coverDate></publicationMeta><publicationMeta level="unit" position="6" status="forIssue" type="article"><doi>10.1111/j.1601-0825.2012.01974.x</doi><idGroup><id type="unit" value="ODI1974"></id></idGroup><countGroup><count number="8" type="pageTotal"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="publisher">© 2012 John Wiley & Sons A/S</copyright><eventGroup><event date="2012-05-28" type="manuscriptReceived"></event><event date="2012-06-25" type="manuscriptRevised"></event><event date="2012-07-09" type="manuscriptAccepted"></event><event agent="SPS" date="2012-07-21" type="xmlCreated"></event><event type="publishedOnlineAccepted" date="2012-07-14"></event><event type="publishedOnlineEarlyUnpaginated" date="2012-08-06"></event><event type="firstOnline" date="2012-08-06"></event><event type="publishedOnlineFinalForm" date="2013-03-21"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-02"></event></eventGroup><numberingGroup><numbering type="pageFirst">271</numbering><numbering type="pageLast">278</numbering></numberingGroup><correspondenceTo>Correspondence: Dr. Jaana Helenius‐Hietala, Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, PO Box 41, Helsinki FI‐00014, Finland. Tel: +358 40 724 7275, Fax: +358 9 191 27286, E‐mail: <email>jaana.s.helenius@helsinki.fi</email></correspondenceTo><selfCitationGroup><citation type="self" xml:id="odi1974-cit-0033"><i>Oral Diseases</i> (2012) doi: 10.1111/j.1601-0825.2012.01974.x</citation></selfCitationGroup><linkGroup><link type="toTypesetVersion" href="file:ODI.ODI1974.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Increased infection risk postliver transplant without pretransplant dental treatment</title><title type="shortAuthors">J Helenius‐Hietala <i>et al</i></title></titleGroup><creators><creator affiliationRef="#odi1974-aff-0001 #odi1974-aff-0002" corresponding="yes" creatorRole="author" xml:id="odi1974-cr-0001"><personName><givenNames>J</givenNames> <familyName>Helenius‐Hietala</familyName></personName></creator><creator affiliationRef="#odi1974-aff-0003" creatorRole="author" xml:id="odi1974-cr-0002"><personName><givenNames>F</givenNames> <familyName>Åberg</familyName></personName></creator><creator affiliationRef="#odi1974-aff-0001 #odi1974-aff-0002" creatorRole="author" xml:id="odi1974-cr-0003"><personName><givenNames>JH</givenNames> <familyName>Meurman</familyName></personName></creator><creator affiliationRef="#odi1974-aff-0003" creatorRole="author" xml:id="odi1974-cr-0004"><personName><givenNames>H</givenNames> <familyName>Isoniemi</familyName></personName></creator></creators><affiliationGroup><affiliation countryCode="FI" type="organization" xml:id="odi1974-aff-0001"><orgDiv>Department of Oral Infectious Diseases</orgDiv> <orgDiv>Institute of Dentistry</orgDiv> <orgName>University of Helsinki</orgName> <address><city>Helsinki</city> <country>Finland</country></address></affiliation> <affiliation countryCode="FI" type="organization" xml:id="odi1974-aff-0002"><orgDiv>Department of Oral and Maxillofacial Diseases</orgDiv> <orgName>Helsinki University Central Hospital</orgName> <address><city>Helsinki</city> <country>Finland</country></address></affiliation><affiliation countryCode="FI" type="organization" xml:id="odi1974-aff-0003"><orgDiv>Transplantation and Liver Surgery Clinic</orgDiv> <orgName>Helsinki University Central Hospital</orgName> <address><city>Helsinki</city> <country>Finland</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="odi1974-kwd-0001">acute liver failure</keyword><keyword xml:id="odi1974-kwd-0002">dental infections</keyword><keyword xml:id="odi1974-kwd-0003">infectious complications</keyword><keyword xml:id="odi1974-kwd-0004">outcome</keyword></keywordGroup><fundingInfo><fundingAgency>EVO</fundingAgency><fundingNumber>T1020Y0011</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Helsinki University Central Hospital</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:id="odi1974-abs-0001"><section xml:id="odi1974-sec-0001"><title type="main">Objective</title><p>Infections cause considerable morbidity after liver transplantation (<fc>LT</fc>). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.</p></section><section xml:id="odi1974-sec-0002"><title type="main">Subjects and methods</title><p>Medical and dental data came from hospital records and infection data from the <fc>F</fc>innish <fc>LT</fc> registry. The follow‐up was until <fc>F</fc>ebruary 2011. Of 51 patients (<fc>LT</fc> during 2000–2006), 16 had and 35 did not have dental treatment pretransplant.</p></section><section xml:id="odi1974-sec-0003"><title type="main">Results</title><p>Univariate <fc>C</fc>ox regression analysis demonstrated a 2.46‐fold (95% <fc>CI</fc> 1.06–5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre‐ and post‐transplant factors, the corresponding infection risk increased, respectively, to 8.17‐fold (95% <fc>CI</fc> 2.19–30.6) and 8.54‐fold (95% <fc>CI</fc> 1.82–40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation.</p></section><section xml:id="odi1974-sec-0004"><title type="main">Conclusion</title><p>High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Increased infection risk postliver transplant without pretransplant dental treatment</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Increased infection risk postliver transplant without pretransplant dental treatment</title></titleInfo><name type="personal"><namePart type="given">J</namePart><namePart type="family">Helenius‐Hietala</namePart><affiliation>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</affiliation><affiliation>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</affiliation><affiliation>E-mail: jaana.s.helenius@helsinki.fi</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F</namePart><namePart type="family">Åberg</namePart><affiliation>Transplantation and Liver Surgery Clinic, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JH</namePart><namePart type="family">Meurman</namePart><affiliation>Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland</affiliation><affiliation>Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Isoniemi</namePart><affiliation>Transplantation and Liver Surgery Clinic, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-04</dateIssued><dateCreated encoding="w3cdtf">2012-07-21</dateCreated><dateCaptured encoding="w3cdtf">2012-05-28</dateCaptured><dateValid encoding="w3cdtf">2012-07-09</dateValid><edition>Oral Diseases (2012) doi: 10.1111/j.1601-0825.2012.01974.x</edition><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life‐threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post‐transplant infectious complications.</abstract><abstract>Medical and dental data came from hospital records and infection data from the Finnish LT registry. The follow‐up was until February 2011. Of 51 patients (LT during 2000–2006), 16 had and 35 did not have dental treatment pretransplant.</abstract><abstract>Univariate Cox regression analysis demonstrated a 2.46‐fold (95% CI 1.06–5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre‐ and post‐transplant factors, the corresponding infection risk increased, respectively, to 8.17‐fold (95% CI 2.19–30.6) and 8.54‐fold (95% CI 1.82–40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation.</abstract><abstract>High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. 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