Incidence, pattern and clinical relevance of microbial contamination of preservation fluid in liver transplantation

Grąt, Michał; Ligocka, Joanna; Lewandowski, Zbigniew; Barski, Krzysztof; Hołówko, Wacław; Skalski, Michał; Kornasiewicz, Oskar; Usarek, Paulina; Zieniewicz, Krzysztof; Młynarczyk, G.; Krawczyk, Marek

doi:10.12659/aot.883454

Cited by 34 publications

(21 citation statements)

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“…Isolate from 10D1, BLASTed to be A. nosocomialis , is more likely to be attributed to contamination of the preservation fluid. Moreover, not all microbial contamination in the preservation fluids would give rise to an infection in recipients because such a transmission still depends on individual susceptibility and anti-infective therapy 34–36 . However, we did not acquire all the A. baumannii isolates from donors during that period.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Drug-resistant Acinetobacter baumannii After DCD Renal Transplantation

Jiang

Cao

et al. 2017

Sci Rep

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Infection after renal transplantation remains a major cause of morbidity and death, especially infection from the extensively drug-resistant bacteria, A. baumannii. A total of fourteen A. baumannii isolates were isolated from the donors’ preserved fluid from DCD (donation after cardiac death) renal transplantation and four isolates in the recipients’ draining liquid at the Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, from March 2013 to November 2014. An outbreak of A. baumannii emerging after DCD renal transplantation was tracked to understand the transmission of the pathogen. PFGE displayed similar DNA patterns between isolates from the same hospital. Antimicrobial susceptibility tests against thirteen antimicrobial agents were determined using the K-B diffusion method and eTest. Whole-genome sequencing was applied to investigate the genetic relationship of the isolates. With the clinical data and research results, we concluded that the A. baumannii isolates 3R1 and 3R2 was probably transmitted from the donor who acquired the bacteria during his stay in the ICU, while isolate 4R1 was transmitted from 3R1 and 3R2 via medical manipulation. This study demonstrated the value of integration of clinical profiles with molecular methods in outbreak investigation and their importance in controlling infection and preventing serious complications after DCD transplantation.

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Section: Discussionmentioning

confidence: 99%

Evolution of Drug-resistant Acinetobacter baumannii After DCD Renal Transplantation

Jiang

Cao

et al. 2017

Sci Rep

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“…The median interval to developing candidiasis post-liver transplant is 151 days with an interquartile range of 14 to 1037 days [2]. Cases reported in reviews of liver preservation fluid (PF) culture positivity [7][8][9], or case reports [4,6,10,11] show an earlier onset.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike donor or procurement risk factors, positivity is a clear indication for antifungal therapy. The frequency of PF contamination by Candida vary between institutions and ranges from 3%-9% in kidney transplantation [16][17][18], and 0.4-4.1% in liver transplantation [8,9,18]. When compared within the same institution using a standardized microbiological protocol, PF contamination in liver transplantation (4.1%) seemed to be slightly higher than that in kidney transplantation (3.1%) [18].…”

Section: Preservation Fluid Culturementioning

confidence: 96%

A Silent and Very Early Post-Liver Transplant Death by Candida Arteritis

Ko¹,

Guerra²,

Garvin³

2019

obm transplant

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Background: Graft site candidiasis is a serious complication after solid organ transplantation, often presenting as invasive arteritis leading to graft loss or even death. Case Report: We report a case of anastomotic site candidiasis leading to arterial rupture and death at postoperative day 10 with no clinical warning signs. Preservation fluid cultures were negative and postoperative Doppler ultrasonography did not show vascular compromise. Postmortem examination revealed microscopic arterial wall abscesses harbouring hyphae and yeast consistent with Candida species. Conclusions: Our case demonstrates a particularly early and silent death post-liver transplant due to Candida arteritis and highlights the limitations of current preventive and screening measures. We discuss potential routes of contamination and control measures.

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“…The preservation solution is of vital importance in increasing the organ's tolerance to warm and cold ischemic damage and to mitigating reperfusion injury (Grat et al, 2012;Voigt & DeLario, 2013). However, The mean is depicted by the line through the center of the box.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular uptake of cyclodextrin‐complexed curcumin during liver preservation: A feasibility study

Saidi

Meurisse

Jochmans

et al. 2017

Biopharm & Drug Disp

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The increasing demand for donor organs and the decreasing organ quality is prompting research toward new methods to reduce ischemia reperfusion injury (IRI). Several strategies have been proposed to protect preserved organs from this injury. Before curcumin/dextrin complex (CDC), a potent antioxidant and anti-inflammatory agent, can be used clinically we need to better understand the intracellular uptake under hypothermic conditions on a rat model of liver donation after circulatory death (DCD) and brain death (DBD). To be able to use the fluorescence of CDC for quantification the stability of CDC in different preservation solutions at 4°C or 37°C was investigated. Livers from Wistar rats were procured after being flushed-out through the portal vein using CDC-enriched preservation solutions and stored at 4°C for variable periods. The CDC signal was stable in different preservation solutions over a period of 4 h and allowed the rapid and lasting uptake of curcumin into cells. After 4 h of preservation, CDC was no longer visible microscopically, and HPLC analysis showed very low to non-detectable tissue levels of CDC, proving metabolization during preservation. However, the distribution of CDC was not affected by warm ischemia damage (p = 0.278) nor by flushing the livers before or after 4 h of cold storage and without a warm preflush. Finally, curcumin reduced oxidative stress, lowered histological injury and did not change gene expression after WI/cold storage. Therefore, the use of CDC flush solution for the initial organ flush can offer a promising approach to the enhancement of liver preservation and the maintenance of its quality.

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Incidence, pattern and clinical relevance of microbial contamination of preservation fluid in liver transplantation

Cited by 34 publications

References 0 publications

Evolution of Drug-resistant Acinetobacter baumannii After DCD Renal Transplantation

Evolution of Drug-resistant Acinetobacter baumannii After DCD Renal Transplantation

A Silent and Very Early Post-Liver Transplant Death by Candida Arteritis

Hepatocellular uptake of cyclodextrin‐complexed curcumin during liver preservation: A feasibility study

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