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Early post‐liver transplantation infections and their effect on long‐term survival
Author(s) -
LeiboviciWeissman Yaara,
Anchel Noa,
Nesher Eviatar,
Leshno Moshe,
Shlomai Amir
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13673
Subject(s) - medicine , liver transplantation , transplantation , retrospective cohort study , pneumonia , multivariate analysis , cohort study , cohort , survival analysis , surgery , gastroenterology
Abstract Background Infections post‐liver transplantation are major drivers for morbidity and mortality. However, the impact of infections within 180 days post‐liver transplantation on long‐term survival is not clear. Methods We present a retrospective cohort of 317 liver transplant patients for whom all infectious episodes were prospectively collected during a mean follow‐up of 4.4 years. Results A total of 143/317 (45%) of patients suffered from any infectious episode during the first 6 months following liver transplantation. Patients with surgical site infections have a reduced survival compared to those with no infection (HR 0.33, 95% CI 0.172‐0.636, P = .001), whereas infections from other sources, including pneumonia, UTI, and line‐related infections, were not associated with increased mortality. Furthermore, even though the presence of any infection within 30 days or 6 months post‐transplantation did not affect survival, more than a single infectious episode per patient was significantly associated with increased mortality (HR 1.70, CI 1.12‐2.60, P = .013). In a multivariate analysis, the number of infectious episodes remained statistically significant (HR 1.58, 95% CI 1.03‐2.43, P = .035) upon adjustment for other major variables associated with comorbidities and infection risk. Conclusions Surgical site infections and the number of infectious episodes within 180 days post‐liver transplantation are major determinants of long‐term survival among these patients.