Infections are leading causes of morbidity among liver transplant (LT) patients. We aimed to study the incidence and risk factors of infection in LDLT patients.
The medical records of 223 adult LDLT from 01/2000 to 08/2015 were reviewed for infections up to 1 year after transplant. We estimated the cumulative incidence of infection using the Kaplan Meier product limit method. Risk factors measured at baseline and over follow-up were analyzed with time-dependent Cox regression modeling.
The majority of patients were Caucasian (n=211, 95%) and male (n=144, 65%); median age was 55 years. The most common reason for transplantation was primary sclerosing cholangitis (38%). Fifty six percent of patients developed an infection within 1 year (n=122), with the majority (80/122, or 66%) within 30 days of transplant. The types of infection are shown in Figure 1. Enterococcus sp. was the most frequent pathogen (29/55). Multivariable analysis showed that MELD score (HR, per 10-point change: 1.65), history of recurrent pre-transplant infections (HR: 2.26), Roux-en-Y anastomosis (HR: 2.24), number of packed RBC transfusions (log-transformed; HR: 1.49), and biliary complications (HR: 3.79) were independently associated with a higher risk of infection.
LDLT recipients are at high risk for infections, especially during the first 30 days after transplant. Most infections were hepatobiliary and related to surgery. LDLT recipients with higher MELD scores and those with history of recurrent infection were at increased risk of infection as well.
Figure 1: Types of Infection In the First Year Post Transplant
LDLT - Living donor liver transplant; OI opportunistic infection; CMV Cytomegalovirus; VZV Varicella zoster virus; CDI C. difficile infection; UTI Urinary tract infection; SSI surgical site infection
C. L. Abad,
R. R. Razonable, None
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