Infectious complication and mortality after Liver Transplantation according to Donor: comparison between Cadaveric and Living Donor Transplantation
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.
S. J. Lee,
S. Lee, None
J. Y. Park, None