Korean J Transplant.  2022 Nov;36(Supple 1):S350. 10.4285/ATW2022.F-4948.

Characteristics of infection during the first year post pediatric liver transplantation: a 12-year single-center experience

• Eiamkulbutr S
• Tubjaroen C
• Anugulruengkitt S
• Songchumsai C
• Chongsrisawat V

• KMID: 2535577
• DOI: http://doi.org/10.4285/ATW2022.F-4948

Abstract

Background
Half of the pediatric liver transplantation (LT) patients developed at least one episode of infection within 6 months after LT. However, few studies reported infections and outcomes after pediatric LT in Thailand. We aim to examine the character-istics of infections and determine the factors associated with infections and clinical outcomes after pediatric LT.
Methods
A retrospective cohort study was conducted in patients aged <18 years who had LT. Medical records were reviewed in the first-year posttransplantation. The risk factors for developing an infection, factors associated with infections and clinical outcomes were evaluated using logistic regression.
Results
From January 2009 to August 2021, 99 cases who had pediatric LT were analyzed. The median (interquartile range) age was 14 months (10–46 months). All patients, except for four patients, completed their follow-up. There were 464 infection episodes within the first-year posttransplantation. The predominant infection sites were in the bloodstream (120, 25.9%) and gastrointestinal tract (68, 14.7%). Overall, bacterial infections accounted for 166 infections (35.7%). The most common bacterial pathogen was Escherichia coli (22.9%). The mean (SD) operative duration was 10 (±1.8) hours and 61.6% took more than 10 hours which was a factor significantly associated with infection post LT (odds ratio, 5.5; 95% confidence interval, 1.0–29.0). The 1-year survival rate post LT was 96.0%. Out of the 4 deaths, three patients died due to infections.
Conclusions
The most common site of infection was in the bloodstream and Gram-negative bacterial infections developed in one-third of the recipients. Prolonged operative duration significantly increased the risk of developing infections post-LT.