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Hepatic abscess: a rare complication after liver transplant
Author(s) -
Kornasiewicz Oskar,
Hołówko Wacław,
Grąt Michał,
Gorski Zuzanna,
Dudek Krzysztof,
RaszejaWyszomirska Joanna,
Krawczyk Marek
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12807
Subject(s) - medicine , liver abscess , abscess , complication , surgery , percutaneous , liver transplantation , blood culture , antibiotics , transplantation , radiology , microbiology and biotechnology , biology
Background This study was conducted to evaluate the predisposing factors, microbiology, treatment, and outcomes associated with hepatic abscess, a rare but serious complication which may accur after an orthotopic liver transplant ( OLT ). Methods This was a retrospective study based on a prospectively maintained database of 1100 patients who underwent OLT at the Medical University of Warsaw. An abscess was defined on imaging as solitary or multiple localized parenchymal collections in patients with clinical signs of infection, with or without positive cultures from blood or abscess aspirate. Results Fifteen patients (1.4%) developed hepatic abscess, including 12 (80%) with multiple abscesses. Predisposing factors included biliary pathology (eight patients), hepaticojejunostomy (six patients), and hepatic artery stenosis or thrombosis (five patients). Ten patients were treated using multiple percutaneous and endoscopic interventional procedures in addition to antimicrobial treatment whereas five were treated solely with antibiotics. Five patients (33.3%) died due to multi‐organ failure secondary to abscess treatment, including one unsuccessful case of re‐ OLT . Thirteen patients (87%) had bacterial growth and five (33.3%) had fungal growth in their blood or abscess aspirates. Conclusions Hepatic abscess after liver transplantation may be treated successfully with percutaneous and endoscopic intervention, along with antibiotics according to the results of microbial cultures of blood and/or abscess aspirates.