Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation – A randomized, double-blind trial

Authors: Nada Rayes, Daniel Seehofeer, Tom Theruvath, Reinhold A Schiller, Jan M Langrehr, Sven Jonas, Stig Bengmark, Peter Neuhaus.

Published: American Journal of Transplantation 2005; 5 125-130.

Method and selection

The study was conducted in vivo, involving human participants.

Design: A randomized, double-blind trial.

Treatment: Enteral nutrition for 14 days starting from the day before liver transplantation surgery. Group A: composition of four lactic acid bacteria, LAB, and four fibers (Synbiotic 2000). Group B: receiving the fibers only.

Where and when: Berlin, Germany

Sample size: 66 recipients.

Sample criteria: Adults scheduled for liver transplantation. Exclusion criteria: decompensated renal insufficiencies and cerebral disorders with danger of aspiration. Also patients with roux and Y-anastomosis.

Analysed material: Thirty day infection rate, length of hospital stay, duration of antibiotics therapy, non infectious complications and side effects of enteral nutrition were recorded.

Results and indicative results

Results

The duration of antibiotic therapy was significantly shorter in patients receiving the synbiotic. (s127).

48% of group B developed some sort of infection, compared to 3% (1 person) receiving a bacterial infection in group A. (s 127-128).

Indicative results

The group receiving LAB significantly reduced the incidence of bacterial nosocomial infections following liver transplantation compared to the group receiving only fibers. This difference is interesting in relation to the fact that more non-infectious complications (that are risk factors for infections) occurred in the group receiving LAB. The infection rates following were also lower than in a previous study where only one strain of probiotics and one fiber was used, which could indicate that the combination of pro- and prebiotics could act synergistically. (s 128).

Early enteral nutrition with a mix of pre- and probiotics is an effective means to prevent post-operative bacterial infections in high risk surgical patients. (s 129).

Further research

Further clinical studies with larger patient numbers that also included measurements of special immune parameters are needed to confirm the preliminary results and to clarify the exact mode of action of pre- and probiotics. (s 129).

Full research study