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447
Infectious complication and mortality after Liver Transplantation according to Donor: comparison between Cadaveric and Living Donor Transplantation

Session: Poster Abstract Session: Transplant Infectious Diseases
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Living donor liver transplantation (LDLT) has been shown to decrease waiting-list mortality and in economic terms, similar overall financial burden to cadaveric donor liver transplantation (CDLT) has been reported. But there are rare studies about infectious complication and mortality after LDLT compared with CDLT. The aim of this study was to evaluate the infectious complication and clinical outcome in LDLT and CDLT group.

Methods: We analyzed the medical records of 148 consecutive liver transplant recipients from May 2010 to march 2014 at Pusan National University Yangsan Hospital, Yangsan Korea.

Results: There were 151 Liver transplantations in 148 patients. Of the 148 patients enrolled, 90 (60.8%) underwent LDLT. Baseline characteristics differed between LDLT versus CDLT group with regard to percentage hepatocellular carcinoma at transplantation (n=57 vs 12, respectively, p=0.00) and transplant model for end-stage liver disease (MELD) score (mean=12.6 vs 26.1, respectively, p=0.00) .

Overall incidence of infectious complications after liver transplantation was 44.5% (64/148) and incidence of infections in CDLT was higher than LDLT group (n=40, 71.4% vs n=25, 27.8%, respectively,  p=0.00)

Bacterial infections were the most common infectious complications (n=55, 85.9%) followed by fungal infections (n=5, 7.8%), viral infections (n=3, 4.7%), and tuberculosis (n=1, 1.6%). Enterococcus spp. (33.3%) were the leading pathogens followed by coagulase-negative staphylococci (17.3%) and E. coli (12.3%). However, the distribution of etiologic agents was not different between CDLT and LDLT group. Intra-abdominal infections (n=24, 16.4%) were the most common type, which were more frequent in CDLT group (n=15, 26.8%) than in LDLT group (n=9, 10.0%) (P=0.008).

 In CDLT group, higher 100-day mortality (n=16,27.6% vs n=4, 4.4%, respectively, p=0.00), longer post operation admission day (mean=50.9±33.6 days vs 32.13±21.8 days, respectively, p=0.00) and longer stay of ICU (mean=23.5±12.7 days vs 10.9±8.9 days, respectively, p=0.00) were observed.

 Conclusion: Our data showed more frequent infectious complication, higher mortality and poor in-hospital outcome in CDLT group than LDLT group. Different in-hospital managing strategies should be considered in CDLT group to reduce infectious complication and mortality.

 

Su Jin Lee, MD1, Sun Hee Lee, MD, PhD2, Shinwon Lee, MD, PhD2 and Ji Young Park, MD3, (1)Internal Medicine, Pusan national university yangsan hospital, yangsansi, South Korea, (2)Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea, (3)Departmnet of Internal Medicine, College of Medicine of Kosin University, Busan, South Korea

Disclosures:

S. J. Lee, None

S. H. Lee, None

S. Lee, None

J. Y. Park, None

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