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Posttransplant bacteremia in adult living donor liver transplant recipients
Author(s) -
Iida Taku,
Kaido Toshimi,
Yagi Shintaro,
Yoshizawa Atsushi,
Hata Koichiro,
Mizumoto Masaki,
Mori Akira,
Ogura Yasuhiro,
Oike Fumitaka,
Uemoto Shinji
Publication year - 2010
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.22165
Subject(s) - medicine , bacteremia , liver transplantation , ascites , surgery , transplantation , mortality rate , gastroenterology , antibiotics , microbiology and biotechnology , biology
Infectious complications such as bacteremia after living donor liver transplantation (LDLT) are associated with significant morbidity and mortality. We retrospectively analyzed the frequency and characteristics of posttransplant bacteremia in 181 adult LDLT recipients between April 2006 and November 2009, and we evaluated the risk factors for posttransplant bacteremia. One hundred seventeen episodes of bacteremia occurred in 62 of 181 recipients (34.3%) within 12 days (median) after transplantation (range = 1‐71 days). The most frequently isolated pathogens were Pseudomonas aeruginosa (26 episodes), methicillin‐resistant coagulase‐negative staphylococci (22 episodes), and Enterococcus sp. (11 episodes). The overall survival rate at 1 year for patients with bacteremia (n = 62) was significantly lower than the rate for patients without bacteremia (n = 119; 69.6% versus 92.3%, respectively, P < 0.0001). Multivariate analysis showed that Child‐Pugh class C ( P = 0.0002), preoperative massive pleural effusion or ascites requiring drainage ( P = 0.0384), postoperative cytomegalovirus infection ( P = 0.0014), ABO incompatibility ( P = 0.0188), and older donor age ( P = 0.015) were independent risk factors for postoperative bacteremia. In conclusion, bacteremia occurred at a high rate after adult LDLT and induced a higher mortality rate in those who developed it. Infection control may play a pivotal role in improving early outcomes after LDLT. Liver Transpl 16:1379–1385, 2010. © 2010 AASLD.