Impacts of pretransplant infections on clinical outcomes of patients with acute-on-chronic liver failure who received living-donor liver transplantation
Liver transplantation is the only therapeutic modality for patients with acute-on chronic liver failure (ACLF). These patients are at high risk for bacterial infections while awaiting transplantation. The aim of this study was to elucidate whether an adequately treated bacterial infection influences...
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| Veröffentlicht in: | PloS one 2013-09, Vol.8 (9), p.e72893-e72893 |
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| creator | Lin, Kuo-Hua Liu, Jien-Wei Chen, Chao-Long Wang, Shih-Hor Lin, Chih-Che Liu, Yueh-Wei Yong, Chee-Chien Lin, Ting-Lung Li, Wei-Feng Hu, Tsung-Hui Wang, Chih-Chi |
| description | Liver transplantation is the only therapeutic modality for patients with acute-on chronic liver failure (ACLF). These patients are at high risk for bacterial infections while awaiting transplantation. The aim of this study was to elucidate whether an adequately treated bacterial infection influences the outcomes after transplantation in this patient population.
54 recipients (median age, 49.5 years [range, 22-60]) of adult-to-adult living donor liver transplant (LDLT) for ACLF were categorized as those with pretransplant infection (Group 1, n=34) or without pretransplant infection (Group 2, n=20) for retrospective analyses. With the exception of a higher male-female ratio (P=0.046) and longer length of pretransplant hospital stay (P=0.026) in Group 1, similar demographic, laboratory and clinical features were found in both groups. Patients in Group 1 (totally 42 pretransplant infection episodes) were adequately treated with effective antibiotic(s) before receiving LDLT. All included patients were followed up until one year after transplantation or death. Sixty-one posttransplant infection episodes were found in an overall of 44 ACLF patients (27 in Group 1 vs. 15 in Group 2; P=0.352). Frequently encountered posttransplant infections were intraabdominal infection, pneumonia, bloodstream infection and urinary tract infection. Two patients died in each group (P=0.622). No significant difference was found in the length of posttransplant ICU stay, and in one-year survival, graft rejection, and posttransplant infection rate between both groups. The longer overall hospital stay (mean day, 89.0 vs. 65.5, P=0.024) found in Group 1 resulted from a longer pretransplant hospital stay receiving treatment for pretransplant infection(s) and/or awaiting transplantation.
These data suggested that an adequately treated pretransplant infection do not pose a significant risk for clinical outcomes including posttransplant fatality in recipients in adult-to-adult LDLT for ACLF. |
| doi_str_mv | 10.1371/journal.pone.0072893 |
| format | Article |
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54 recipients (median age, 49.5 years [range, 22-60]) of adult-to-adult living donor liver transplant (LDLT) for ACLF were categorized as those with pretransplant infection (Group 1, n=34) or without pretransplant infection (Group 2, n=20) for retrospective analyses. With the exception of a higher male-female ratio (P=0.046) and longer length of pretransplant hospital stay (P=0.026) in Group 1, similar demographic, laboratory and clinical features were found in both groups. Patients in Group 1 (totally 42 pretransplant infection episodes) were adequately treated with effective antibiotic(s) before receiving LDLT. All included patients were followed up until one year after transplantation or death. Sixty-one posttransplant infection episodes were found in an overall of 44 ACLF patients (27 in Group 1 vs. 15 in Group 2; P=0.352). Frequently encountered posttransplant infections were intraabdominal infection, pneumonia, bloodstream infection and urinary tract infection. Two patients died in each group (P=0.622). No significant difference was found in the length of posttransplant ICU stay, and in one-year survival, graft rejection, and posttransplant infection rate between both groups. The longer overall hospital stay (mean day, 89.0 vs. 65.5, P=0.024) found in Group 1 resulted from a longer pretransplant hospital stay receiving treatment for pretransplant infection(s) and/or awaiting transplantation.
These data suggested that an adequately treated pretransplant infection do not pose a significant risk for clinical outcomes including posttransplant fatality in recipients in adult-to-adult LDLT for ACLF.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0072893</identifier><identifier>PMID: 24023787</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acinetobacter baumannii ; Adult ; Antibiotics ; Bacteria ; Bacterial infections ; Bacterial Infections - complications ; Care and treatment ; Complications and side effects ; Demographics ; Drug resistance ; Fatalities ; Female ; Graft Rejection ; Graft Survival ; Health risks ; Hospitals ; Humans ; Infections ; Internal medicine ; Liver ; Liver diseases ; Liver failure ; Liver Failure - microbiology ; Liver Failure - surgery ; Liver Transplantation ; Liver transplants ; Male ; Medicine ; Middle Aged ; Mortality ; Pathogens ; Patient outcomes ; Patients ; Physicians ; Physiological aspects ; Pneumonia ; Retrospective Studies ; Sepsis ; Surgery ; Transplantation ; Transplants & implants ; Urinary tract ; Urinary tract infections ; Young Adult</subject><ispartof>PloS one, 2013-09, Vol.8 (9), p.e72893-e72893</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Lin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Lin et al 2013 Lin et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-f027c900d372678841f8a2fd9dd25a3f3e92622fecb7b5fcb689a9e347bdcbf63</citedby><cites>FETCH-LOGICAL-c692t-f027c900d372678841f8a2fd9dd25a3f3e92622fecb7b5fcb689a9e347bdcbf63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759387/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759387/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24023787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Kuo-Hua</creatorcontrib><creatorcontrib>Liu, Jien-Wei</creatorcontrib><creatorcontrib>Chen, Chao-Long</creatorcontrib><creatorcontrib>Wang, Shih-Hor</creatorcontrib><creatorcontrib>Lin, Chih-Che</creatorcontrib><creatorcontrib>Liu, Yueh-Wei</creatorcontrib><creatorcontrib>Yong, Chee-Chien</creatorcontrib><creatorcontrib>Lin, Ting-Lung</creatorcontrib><creatorcontrib>Li, Wei-Feng</creatorcontrib><creatorcontrib>Hu, Tsung-Hui</creatorcontrib><creatorcontrib>Wang, Chih-Chi</creatorcontrib><title>Impacts of pretransplant infections on clinical outcomes of patients with acute-on-chronic liver failure who received living-donor liver transplantation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Liver transplantation is the only therapeutic modality for patients with acute-on chronic liver failure (ACLF). These patients are at high risk for bacterial infections while awaiting transplantation. The aim of this study was to elucidate whether an adequately treated bacterial infection influences the outcomes after transplantation in this patient population.
54 recipients (median age, 49.5 years [range, 22-60]) of adult-to-adult living donor liver transplant (LDLT) for ACLF were categorized as those with pretransplant infection (Group 1, n=34) or without pretransplant infection (Group 2, n=20) for retrospective analyses. With the exception of a higher male-female ratio (P=0.046) and longer length of pretransplant hospital stay (P=0.026) in Group 1, similar demographic, laboratory and clinical features were found in both groups. Patients in Group 1 (totally 42 pretransplant infection episodes) were adequately treated with effective antibiotic(s) before receiving LDLT. All included patients were followed up until one year after transplantation or death. Sixty-one posttransplant infection episodes were found in an overall of 44 ACLF patients (27 in Group 1 vs. 15 in Group 2; P=0.352). Frequently encountered posttransplant infections were intraabdominal infection, pneumonia, bloodstream infection and urinary tract infection. Two patients died in each group (P=0.622). No significant difference was found in the length of posttransplant ICU stay, and in one-year survival, graft rejection, and posttransplant infection rate between both groups. The longer overall hospital stay (mean day, 89.0 vs. 65.5, P=0.024) found in Group 1 resulted from a longer pretransplant hospital stay receiving treatment for pretransplant infection(s) and/or awaiting transplantation.
These data suggested that an adequately treated pretransplant infection do not pose a significant risk for clinical outcomes including posttransplant fatality in recipients in adult-to-adult LDLT for ACLF.</description><subject>Acinetobacter baumannii</subject><subject>Adult</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Bacterial infections</subject><subject>Bacterial Infections - complications</subject><subject>Care and treatment</subject><subject>Complications and side effects</subject><subject>Demographics</subject><subject>Drug resistance</subject><subject>Fatalities</subject><subject>Female</subject><subject>Graft Rejection</subject><subject>Graft Survival</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Internal medicine</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Liver failure</subject><subject>Liver Failure - microbiology</subject><subject>Liver Failure - surgery</subject><subject>Liver Transplantation</subject><subject>Liver transplants</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pathogens</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Physicians</subject><subject>Physiological aspects</subject><subject>Pneumonia</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Surgery</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Urinary tract</subject><subject>Urinary tract infections</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEoqXwBggiISG4yOLYTpzcIFUVh5UqVeJ0azk-bLxy7K3ttPAmPC5ONy0b1AuUi0Qz3_9PZuzJsuclWJWIlO-2bvSWmdXOWbkCgMCmRQ-y47JFsKghQA8Pvo-yJyFsAahQU9ePsyOIAUSkIcfZ7_WwYzyG3Kl852X0zIadYTbm2irJo3Y25WzOjbaaM5O7MXI3yL2ARS1tEl_r2OeMj1EWzha89y7BudFX0ueKaTN6mV_3LveSyxQUU0rbTSGcdX7m_pZmU9Wn2SPFTJDP5vdJ9v3jh29nn4vzi0_rs9PzgtctjIUCkPAWAIEIrEnT4FI1DCrRCgErhhSSLawhTK10pKsU7-qmZa1EmHSCd6pGJ9nLve_OuEDnoQZaYtjisqwblIj1nhCObenO64H5X9QxTW8Czm8o81FzIymrGohLAjsEBW6xZA3sMKm7jggBEMPJ6_1cbewGKXianmdmYbrMWN3TjbuiiFQtakgyeDMbeHc5yhDpoAOXJs1NunH6bwQBIRUACX31D3p_dzO1YamBdOgu1eWTKT3FpMG4bAlM1OoeKj1CDpqnG6h0ii8EbxeCxET5M27YGAJdf_3y_-zFjyX7-oDtJTOxD86MNxd1CeI9yL0LwUt1N-QS0GmBbqdBpwWi8wIl2YvDA7oT3W4M-gPHqRoJ</recordid><startdate>20130902</startdate><enddate>20130902</enddate><creator>Lin, Kuo-Hua</creator><creator>Liu, Jien-Wei</creator><creator>Chen, Chao-Long</creator><creator>Wang, Shih-Hor</creator><creator>Lin, Chih-Che</creator><creator>Liu, Yueh-Wei</creator><creator>Yong, Chee-Chien</creator><creator>Lin, Ting-Lung</creator><creator>Li, Wei-Feng</creator><creator>Hu, Tsung-Hui</creator><creator>Wang, Chih-Chi</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130902</creationdate><title>Impacts of pretransplant infections on clinical outcomes of patients with acute-on-chronic liver failure who received living-donor liver transplantation</title><author>Lin, Kuo-Hua ; Liu, Jien-Wei ; Chen, Chao-Long ; Wang, Shih-Hor ; Lin, Chih-Che ; Liu, Yueh-Wei ; Yong, Chee-Chien ; Lin, Ting-Lung ; Li, Wei-Feng ; Hu, Tsung-Hui ; Wang, Chih-Chi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-f027c900d372678841f8a2fd9dd25a3f3e92622fecb7b5fcb689a9e347bdcbf63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acinetobacter baumannii</topic><topic>Adult</topic><topic>Antibiotics</topic><topic>Bacteria</topic><topic>Bacterial infections</topic><topic>Bacterial Infections - complications</topic><topic>Care and treatment</topic><topic>Complications and side effects</topic><topic>Demographics</topic><topic>Drug resistance</topic><topic>Fatalities</topic><topic>Female</topic><topic>Graft Rejection</topic><topic>Graft Survival</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Internal medicine</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Liver failure</topic><topic>Liver Failure - microbiology</topic><topic>Liver Failure - surgery</topic><topic>Liver Transplantation</topic><topic>Liver transplants</topic><topic>Male</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pathogens</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Physicians</topic><topic>Physiological aspects</topic><topic>Pneumonia</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Surgery</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Urinary tract</topic><topic>Urinary tract infections</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Kuo-Hua</creatorcontrib><creatorcontrib>Liu, Jien-Wei</creatorcontrib><creatorcontrib>Chen, Chao-Long</creatorcontrib><creatorcontrib>Wang, Shih-Hor</creatorcontrib><creatorcontrib>Lin, Chih-Che</creatorcontrib><creatorcontrib>Liu, Yueh-Wei</creatorcontrib><creatorcontrib>Yong, Chee-Chien</creatorcontrib><creatorcontrib>Lin, Ting-Lung</creatorcontrib><creatorcontrib>Li, Wei-Feng</creatorcontrib><creatorcontrib>Hu, Tsung-Hui</creatorcontrib><creatorcontrib>Wang, Chih-Chi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints in Context (Gale)</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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These patients are at high risk for bacterial infections while awaiting transplantation. The aim of this study was to elucidate whether an adequately treated bacterial infection influences the outcomes after transplantation in this patient population.
54 recipients (median age, 49.5 years [range, 22-60]) of adult-to-adult living donor liver transplant (LDLT) for ACLF were categorized as those with pretransplant infection (Group 1, n=34) or without pretransplant infection (Group 2, n=20) for retrospective analyses. With the exception of a higher male-female ratio (P=0.046) and longer length of pretransplant hospital stay (P=0.026) in Group 1, similar demographic, laboratory and clinical features were found in both groups. Patients in Group 1 (totally 42 pretransplant infection episodes) were adequately treated with effective antibiotic(s) before receiving LDLT. All included patients were followed up until one year after transplantation or death. Sixty-one posttransplant infection episodes were found in an overall of 44 ACLF patients (27 in Group 1 vs. 15 in Group 2; P=0.352). Frequently encountered posttransplant infections were intraabdominal infection, pneumonia, bloodstream infection and urinary tract infection. Two patients died in each group (P=0.622). No significant difference was found in the length of posttransplant ICU stay, and in one-year survival, graft rejection, and posttransplant infection rate between both groups. The longer overall hospital stay (mean day, 89.0 vs. 65.5, P=0.024) found in Group 1 resulted from a longer pretransplant hospital stay receiving treatment for pretransplant infection(s) and/or awaiting transplantation.
These data suggested that an adequately treated pretransplant infection do not pose a significant risk for clinical outcomes including posttransplant fatality in recipients in adult-to-adult LDLT for ACLF.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24023787</pmid><doi>10.1371/journal.pone.0072893</doi><tpages>e72893</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_1429411683 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acinetobacter baumannii Adult Antibiotics Bacteria Bacterial infections Bacterial Infections - complications Care and treatment Complications and side effects Demographics Drug resistance Fatalities Female Graft Rejection Graft Survival Health risks Hospitals Humans Infections Internal medicine Liver Liver diseases Liver failure Liver Failure - microbiology Liver Failure - surgery Liver Transplantation Liver transplants Male Medicine Middle Aged Mortality Pathogens Patient outcomes Patients Physicians Physiological aspects Pneumonia Retrospective Studies Sepsis Surgery Transplantation Transplants & implants Urinary tract Urinary tract infections Young Adult |
| title | Impacts of pretransplant infections on clinical outcomes of patients with acute-on-chronic liver failure who received living-donor liver transplantation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T10%3A33%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impacts%20of%20pretransplant%20infections%20on%20clinical%20outcomes%20of%20patients%20with%20acute-on-chronic%20liver%20failure%20who%20received%20living-donor%20liver%20transplantation&rft.jtitle=PloS%20one&rft.au=Lin,%20Kuo-Hua&rft.date=2013-09-02&rft.volume=8&rft.issue=9&rft.spage=e72893&rft.epage=e72893&rft.pages=e72893-e72893&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0072893&rft_dat=%3Cgale_plos_%3EA478441972%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1429411683&rft_id=info:pmid/24023787&rft_galeid=A478441972&rft_doaj_id=oai_doaj_org_article_a5824172b32d494ea82b476bb7dd03a4&rfr_iscdi=true |