Microbiologic contamination of intraoperative blood salvaged during liver transplantation.
Bacterial contamination is one of the potential risks of blood salvage and reinfusion during orthotopic liver transplantation (OLT) because cell-saver machines lack antibacterial protection devices. This study was designed to analyze the potential bacterial contamination of blood salvaged during OLT; a secondary end point was to evaluate whether reinfusion of potentially contaminated blood may have been responsible for clinically manifested infective complications in the same patient. After induction of anesthesia, a blood sample was drawn from the central venous catheter (CVC) immediately after its positioning, to exclude potential coexisting hematic contamination of the recipient. During the procedure, 2 other samples of salvaged blood were collected for bacteriological analysis. Twenty-six of 38 samples of salvaged blood were positive for microorganisms, whereas 12 did not reveal the presence of infectious agents. In 19 of 26 positive samples, Staphylococcus species (73%) were isolated with only 2 of 38 samples drawn from CVC being contaminated. Candida Albicans was cultured in 2 samples. The high percentage (73%) of coagulase-negative Staphylococci indicates that blood contamination could have been caused by microorganisms from the air or suctioned from contact surfaces and the surgical field. Although almost 70% of processed and reinfused units tested positive for microbes, none of the postoperative blood cultures (at day 1 and day 3) revealed growth of the same species, not even in the 2 patients who had positive CVC cultures after induction of anesthesia.
Feltracco
P
P
Department of Pharmacology and Anesthesiology University Hospital of Padova, Padova, Italy. paolofeltracco@inwind.it
Michieletto
E
E
Barbieri
S
S
Serra
E
E
Rizzi
S
S
Salvaterra
F
F
Cillo
U
U
Ori
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002176:Candida albicans / Q000302:isolation & purification; D004866:Equipment Contamination; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013210:Staphylococcus / Q000302:isolation & purification; D065227:Transfusion Reaction