Association Between Pre-Transplant Oral Health and Post-Liver Transplant Complications

Abstract

Oral disease is linked with systemic inflammation and various systemic conditions, including chronic liver disease. Liver transplantation (LT) candidates often need dental infection focus eradication, and after LT, there is high risk of many inflammation-related complications. We studied whether pre-LT dental status is associated with the occurrence of post-LT complications. This study included 225 adult LT recipients whose teeth were examined and treated before LT, and 40 adult LT recipients who did not have pre-LT dental data available. Data on post-LT complications were collected from the national liver transplant registry and followed up until the end of July 2020. Worse pre-LT dental status was associated with a higher risk of acute rejection post-LT compared to patients with good dental status. Worse dental status was also associated with higher 1-year-post-LT ALT levels and lower albumin levels. In conclusion, poor pre-LT oral health seems to associate with an increased risk of post-LT acute rejection and with elevated ALT levels and decreased albumin levels, suggesting an effect on post-LT liver health. Therefore, prevention and treatment of oral and dental diseases should be promoted early in the course of liver disease.

Keywords: acute rejection; infection foci; liver transplantation; oral disease; oral health.

Graphical abstract

FIGURE 1

Liver transplant (LT) recipients with a high need for dental treatment (high MTDI) and multiple infection foci pre-LT expressed significantly more acute rejection post-LT compared to LT recipients with a low or no need for dental treatment (low MTDI) pre-LT.