OI had no impact on patient or graft survival at 12 months post transplant. In the era of contemporary immunosuppression and prophylaxis, a significant proportion of OI occur beyond 6 months. Additional strategies may be important to reduce the incidence of such late-onset infections.
Background
Early (<1 month) bacterial infection after liver transplant is a major cause of morbidity and mortality among liver transplant recipients. We investigated the impact of pre‐transplant bacterial infection on early post‐transplant bacterial infection incidence and outcomes.
Methods
A retrospective cohort study identified all patients who underwent liver transplantation between January 1, 2011, and December 31, 2012, at a single tertiary center in the United States. Infections occurring within the 30 days prior to transplant and within the 30 following transplant were identified. Information regarding pre‐transplant morbidity and post‐transplant outcomes was collected.
Results
One‐hundred seventy‐four patients were included in the study. Forty patients (23%) experienced a total of 50 pre‐transplant infections. Fifty‐two (30%) developed a total of 62 post‐transplant infections. Patients with a pre‐transplant infection were more likely to develop a post‐transplant infection compared to patients without a pre‐transplant infection (48% [19 of 40] vs. 25% [33 of 134], respectively, P = .006). Patients with a pre‐transplant infection had a longer mean post‐transplant length of stay compared to those without a pre‐transplant infection (16.3 days vs. 10.4 days, respectively, P < .001), but survival at 30 days was similar in both groups (95% [38 of 40] vs. 97% [130 of 134, respectively, P = .56).
Conclusions
Among liver transplant recipients, pre‐transplant infection is an important risk factor for early post‐transplant bacterial infections. Pre‐transplant infection is associated with increased early morbidity but not mortality after transplant.
Opportunistic infections remain a common complication of solid organ transplantation. Despite significant changes in immunosuppression and infectious diseases prophylaxis, data are limited on the contemporary epidemiology and outcomes of opportunistic infections. Alemtuzumab, a potent lymphocyte-depleting antibody, has been used with increased frequency in solid organ transplant recipients in the last decade. A literature review was performed to summarize the current understanding of the epidemiology, risk factors, and outcomes of opportunistic infections complicating solid organ transplantation with and without alemtuzumab induction therapy. Areas where data are limited regarding opportunistic infections in solid organ transplantation with alemtuzumab induction are indicated.
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