Infectious complications in liver transplantation.
Thirty-five patients received 42 liver homografts between February 1984 and August 1985. One or more infections developed in 23 patients (66%) some time after transplantation. An average of 2.5 infections per infected patient occurred. Of 37 bacterial infections, two thirds were either bacteremias or localized intra-abdominal infections. The median onset was 29 days after operation. Thirteen viral infections were identified, with a median onset of 18 days after operation. Nine fungal infections, six disseminated and three localized, were identified, with a median onset of nine days after operation. Infection was the primary cause of death in five (14%) of 35 patients. Fatal infections were evenly distributed among bacterial (two), fungal (three), and viral (two) pathogens. Despite advances in surgical techniques and the use of cyclosporine, infection after orthotopic liver transplantation is a serious problem. Certain patients can be identified as high risks for infection and require an aggressive diagnostic workup followed by early institution of antimicrobial therapy.
Colonna
J O
JO
Department of Surgery, UCLA-Center for the Health Sciences 90024.
Winston
D J
DJ
Brill
J E
JE
Goldstein
L I
LI
Hoff
M P
MP
Hiatt
J R
JR
Quinones-Baldrich
W
W
Ramming
K P
KP
Busuttil
R W
RW
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology; D006090:Gram-Negative Bacteria; D006801:Humans; D007223:Infant; D017053:Infection Control; D007239:Infections / Q000188:drug therapy / Q000209:etiology*; D016031:Liver Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D014777:Virus Diseases / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents