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

Peter W Schreiber, Heike A Bischoff-Ferrari, Katia Boggian, Christian Van Delden, Natalia Enriquez, Thomas Fehr, Christian Garzoni, Hans H Hirsch, Cédric Hirzel, Oriol Manuel, Pascal Meylan, Lanja Saleh, Maja Weisser, Nicolas J Mueller & Swiss Transplant Cohort Study (STCS)

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. This article is protected by copyright. All rights reserved.
   
citation Schreiber P W, Bischoff-Ferrari H A, Boggian K, van Delden C, Enriquez N, Fehr T, Garzoni C, Hirsch H H, Hirzel C, Manuel O, Meylan P, Saleh L, Weisser M, Mueller N J, Swiss Transplant Cohort Study (STCS) . Vitamin D status and risk of infections after liver transplantation in the Swiss Transplant Cohort Study. Transpl Int 2018;.
   
type journal paper/review (English)
date of publishing 12-08-2018
journal title Transpl Int
ISSN electronic 1432-2277
PubMed 30099788
DOI 10.1111/tri.13328