J Korean Soc Transplant.  2011 Dec;25(4):257-263. 10.4285/jkstn.2011.25.4.257.

Impact of Early Positive Culture Results on the Short-term Outcomes of Liver Transplants

• Cho I
• Joo DJ
• Kim MS
• Yong DE
• Huh KH
• Choi GH
• Choi JS
• Kim SI

• KMID: 1450974
• DOI: http://doi.org/10.4285/jkstn.2011.25.4.257

Abstract

BACKGROUND
Infection is a major cause of morbidity and mortality following liver transplants. We evaluated the risk factors of mortality within 1 month of liver transplantation caused by post-transplant infections.
METHODS
We retrospectively reviewed the medical records of 199 patients who underwent liver transplants from September 2005 to August 2010. We divided the enrolled patients into 3 groups. The first group, the Culture(-) group, was defined as those who had no significant culture results. The second group, the Culture(+)/survival group, was defined as those who tested positive for culture but survived longer than 1 month after transplantation. The third group, the Culture(+)/mortality group, was defined as those who died within 1 month of the transplant with positive culture test results.
RESULTS
The culture(+)/mortality group consisted of more deceased donor liver transplants than other groups. Also, the Culture(+)/mortality group showed more evidence of pre-transplant infections, intensive care unit (ICU) admission, continuous post-transplant renal replacement therapy (CRRT), and a higher MELD score than other groups. The risk factors of early mortality combined with infection 1 month after liver transplantation are hospitalization in ICU before transplantation (HR=16.3, CI=2.6~102.3, P=0.003) and the positive results of culture within 7 days of the operation (HR=38.7, CI=4.1~368.8, P=0.001).
CONCLUSIONS
Hospitalization in ICU before transplantation and an early positive culture result can be an early clinical indicator of a good prognosis after liver transplantation.

Keyword

Infection; Liver transplantation; Culture

MeSH Terms

Hospitalization
Humans
Intensive Care Units
Liver
Liver Transplantation
Medical Records
Prognosis
Renal Replacement Therapy
Retrospective Studies
Risk Factors
Tissue Donors
Transplants

Figure

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  Fig. 1. Sites and organisms of positive culture results within 7 days after liver transplantation. (A) Positive culture results of each sample. (B) Organism distribution of positive culture results.

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  Fig. 2. Organism distribution according to the culture site (n=60, data were duplicately included).

Reference

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