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Vitamin D status and risk of infections after liver transplantation in the Swiss Transplant Cohort Study


Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J; Swiss Transplant Cohort Study (2019). Vitamin D status and risk of infections after liver transplantation in the Swiss Transplant Cohort Study. Transplant International, 32(1):49-58.

Abstract

MAIN PROBLEM Increasing evidence indicates a role of vitamin D in the immune system affecting response to infections. We aimed to characterize the role of vitamin D status, i.e. deficiency (25-OH vitamin D [25-OHD] < 50nmol/l) and no deficiency (25-OHD ≥ 50nmol/l) in incident infections after liver transplantation. METHODS In 135 liver transplant recipients blood samples drawn at time of liver transplantation and 6 months afterwards were used to determine 25-OHD levels. Incident infections episodes were prospectively collected within the STCS database. Poisson regression was applied to address associations between vitamin D status and incident infections. RESULTS Vitamin D deficiency was common at time of transplantation and 6 months afterwards without a significant change in median 25-OHD levels. In univariable analyses vitamin D deficiency was a risk factor for incident infections in the first 6 months post-transplant (IRR 1.52, 95% CI 1.08-2.15, P=0.018) and for bacterial infections occurring after 6 up to 30 months post-transplant (IRR 2.29, 95% CI 1.06-4.94, P=0.034). These associations were not detectable in multivariable analysis with adjustment for multiple confounders. CONCLUSIONS Efforts to optimize vitamin D supplementation in liver transplant recipients are needed. Our data question the role of vitamin D deficiency in incident infections.

Abstract

MAIN PROBLEM Increasing evidence indicates a role of vitamin D in the immune system affecting response to infections. We aimed to characterize the role of vitamin D status, i.e. deficiency (25-OH vitamin D [25-OHD] < 50nmol/l) and no deficiency (25-OHD ≥ 50nmol/l) in incident infections after liver transplantation. METHODS In 135 liver transplant recipients blood samples drawn at time of liver transplantation and 6 months afterwards were used to determine 25-OHD levels. Incident infections episodes were prospectively collected within the STCS database. Poisson regression was applied to address associations between vitamin D status and incident infections. RESULTS Vitamin D deficiency was common at time of transplantation and 6 months afterwards without a significant change in median 25-OHD levels. In univariable analyses vitamin D deficiency was a risk factor for incident infections in the first 6 months post-transplant (IRR 1.52, 95% CI 1.08-2.15, P=0.018) and for bacterial infections occurring after 6 up to 30 months post-transplant (IRR 2.29, 95% CI 1.06-4.94, P=0.034). These associations were not detectable in multivariable analysis with adjustment for multiple confounders. CONCLUSIONS Efforts to optimize vitamin D supplementation in liver transplant recipients are needed. Our data question the role of vitamin D deficiency in incident infections.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 January 2019
Deposited On:06 Sep 2018 09:48
Last Modified:17 Sep 2019 19:26
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0934-0874
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/tri.13328
PubMed ID:30099788

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