Impact of pretransplant infections on clinical outcomes of liver transplant recipients

Liver Transpl. 2010 Feb;16(2):222-8. doi: 10.1002/lt.21982.

Abstract

Whether pretransplant nonviral infections influence outcomes after transplantation in liver transplant recipients in the current era is not well defined. One hundred consecutive patients undergoing liver transplantation in 2005-2008 were studied. Demographics, posttransplant clinical events, and mortality were compared between recipients with and without infections within 12 months before transplantation. In all, 32% of the patients (32/100) developed 45 episodes of pretransplant infections, which included spontaneous bacterial peritonitis (35.6%), bloodstream infections (28.9%), cellulitis (13.3%), pneumonia (8.9%), urinary tract infections (6.7%), and other infections (6.7%). Compared with 68 recipients without pretransplant infections, those with infections had a higher Model for End-Stage Liver Disease score and a lower likelihood of transplantation from home and required longer and more frequent hospital care before and after transplantation (P < 0.05). Mortality at 90 (9.4% versus 2.9%) and 180 days (15.6% versus 10.3%) post-transplant did not differ significantly between recipients with and without pretransplant infections (P = not significant). A higher Model for End-Stage Liver Disease score (P < 0.05) and posttransplant infections (P < 0.05 and P < 0.001), but not pretransplant infections, were associated with posttransplant mortality at 90 and 180 days. In conclusion, pretransplant infections that have been adequately treated do not pose a significant risk for poor outcomes, including posttransplant mortality.

MeSH terms

  • Adult
  • Aged
  • Bacterial Infections / mortality*
  • Cellulitis / mortality
  • Comorbidity
  • Female
  • Humans
  • Liver Failure / mortality*
  • Liver Failure / surgery*
  • Liver Transplantation / mortality*
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / mortality
  • Preoperative Period
  • Risk Factors
  • Urinary Tract Infections / mortality