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

Journal Paper/Review - Aug 12, 2018

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Schreiber P, Bischoff-Ferrari H, Boggian K, Van Delden C, Enriquez N, Fehr T, Garzoni C, Hirsch H, Hirzel C, Manuel O, Meylan P, Saleh L, Maja W, Mueller N, Swiss Transplant Cohort Study (STCS). Vitamin D status and risk of infections after liver transplantation in the Swiss Transplant Cohort Study. Transpl Int 2018
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Journal Paper/Review (English)
Journal
Transpl Int 2018
Publication Date
Aug 12, 2018
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1432-2277
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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. This article is protected by copyright. All rights reserved.