Ann Surg Treat Res.  2018 Mar;94(3):154-158. 10.4174/astr.2018.94.3.154.

Bacterial infection monitoring in the early period after liver transplantation

• Lee JS
• Lee SH
• Kim KS
• Gil EM
• Choi GS
• Kim JM
• Peck KR
• Kwon CH
• Joh JW
• Lee SK

• KMID: 2405328
• DOI: http://doi.org/10.4174/astr.2018.94.3.154

Abstract

PURPOSE
Infection remains the main cause of morbidity and mortality in liver transplantation (LT) recipients; however infection is notoriously difficult to diagnose because its usual signs and symptoms of infection may be masked or absent. This study comprises an analysis of bacterial infections in the early period after LT.
METHODS
This is a study of 129 adults who underwent LT from January 2013 to December 2013, and it includes patients who were followed daily from the day of transplantation to 1-week posttransplantation using bacteriological cultures of blood, urine, sputum, and drained ascites.
RESULTS
The following factors were significantly different between the positive and negative culture groups: living donor LT vs. deceased donor LT (odds ratio [OR], 3.269; P = 0.003), model for end-stage liver disease score (OR, 4.364; P < 0.001), and Child-Pugh classification (P = 0.007). Neither positive culture nor negative culture was associated with infection within 4 weeks of surgery (P = 0.03), and most events were due to surgical complications (75%).
CONCLUSION
Since the full effect of immunosuppression is not yet present during the first month after LT, we suggest that the number of bacterial culture test could be reduced such that they are performed every other day depending on patient's situation.

Keyword

Culture techniques; Infection; Liver transplantation

MeSH Terms

Adult
Ascites
Bacterial Infections*
Classification
Culture Techniques
Humans
Immunosuppression
Liver Diseases
Liver Transplantation*
Liver*
Living Donors
Masks
Mortality
Sputum
Tissue Donors

Figure

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  Fig. 1 Number of culture positive samples. POD, postoperative day.

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  Fig. 2 (A) Infection events occurring between culture positive and culture negative. (B) Proportion of infection event after liver transplantation.

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