Infections After Liver Transplantation: A Retrospective, Single-center Study

Abstract

Objective. To access the incidence of infectious problems after liver transplantation (LT).Design. A retrospective, single-center study. Materials and Methods. Patients undergoing LT from January 2008 to December 2011 were considered. Exclusion criterion was death occurring in the first 48 hours after LT. We determined the site of infection and the bacterial isolates and collected and compared recipient's variables, graft variables, surgical data, post-LT clinical data. Results. Of the 492 patients who underwent LT and the 463 considered for this study, 190 (Group 1, 41%) developed at least 1 infection, with 298 infections detected. Of these, 189 microorganisms were isolated, 81 (51%) gram-positive bacteria (most frequently Staphylococcus spp). Biliary infections were more frequent (mean time of 160.4 AE 167.7 days after LT); from 3 months after LT, gram-negative bacteria were observed (57%). Patients with infections after LT presented lower aminotransferase levels, but higher requirements in blood transfusions, intraoperative vasopressors, hemodialysis, and hospital stay. Operative and cold ischemia times were similar. Conclusion. We found a 41% incidence of all infections in a 2-year follow-up after LT. Gram-positive bacteria were more frequent isolated; however, negative bacteria were commonly isolated later. Clinical data after LT were more relevant for the development of infections. Donors' variables should be considered in future analyses.

Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions

“…Bacterial infections, especially those caused by nosocomial pathogens, are more common during the early post-transplant period (0-1 mo). Surgical complications can lead to wound infections, peritonitis, hepatic artery thrombosis, and biliary tract ischemia that can cause biloma or strictures, increasing the risk of recurrent cholangitis[ 12 , 71 , 72 ]. Other factors contributing to bacterial infections in the early postoperative period include mechanical ventilation, prolonged ICU stay, alteration of the mucocutaneous barrier, vascular and urinary catheterization, and profound immunosuppression[ 73 ].…”

“…Other factors contributing to bacterial infections in the early postoperative period include mechanical ventilation, prolonged ICU stay, alteration of the mucocutaneous barrier, vascular and urinary catheterization, and profound immunosuppression[ 73 ]. A retrospective study including 463 LTR over a 3-year period identified at least one infection in 41% of cases, with biliary tract infections and infections due to staphylococci representing the most common types[ 72 ].…”

Procalcitonin, a Biomarker for Diagnosing and Differentiating Infection among Liver Transplant Recipients: a systematic review and meta-analysis

“…Significant infection accounts for most of the morbidity and mortality after liver transplantation (LT) [1], risk factors of which relate to operation procedures, recipients and donors. Specifically, these include intra-operative ischemia-reperfusion damage, quality of donated organs, level and type of immunosuppression, preoperatively impaired nutritional status, as well as recipients' scores of Model 3 for End-stage Liver Disease (MELD) or other criteria [2,3]. Following this multi-factorial disease, lung infection, sepsis, systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS) tend to arise in clinical settings, causing an inflammatory cascade of vicious circles [4].…”

Infecções Relacionadas À Assistência À Saúde E Fatores Associados No Pós-Operatório De Transplante Hepático

“…This fact may be associated with the small number of transfusions in the sample or with autologous transfusion, which is performed during the LT of the hospital institution of this study, through a process of blood collection and reinfusion, with the objective of reducing and, if possible, eliminating the need for allogeneic blood transfusion, reducing the probable infectious and noninfectious complications. 17 Researches carried out with liver receptors have identified that the transfusion of blood products was associated with the development of PO infection, which contributes to increased morbidity and mortality after LT. 4,12,18 The length of stay in the PO was greater among patients who have acquired HCRI in comparison to those who have not acquired it, showing statistically significant association. These findings corroborate the result of another study that points to the prolonged time of hospitalization as a risk factor for the development of HCRI in liver recipients, conducted in a university hospital located in Korea, where 144 patients were assessed.…”