[Pulmonary infection and its risk factors after orthotopic liver transplantation].
OBJECTIVE
To investigate the characteristics of pulmonary infection and its risk factors after orthotopic liver transplantation (OLT).


METHODS
Clinical data of 250 cases having liver transplantations from April 2001 to August 2005 were retrospectively studied in order to analyse the differences between patients with and without pulmonary infection.


RESULTS
Fifty-seven (57/250, 22.8%) recipients had 72 episodes of pulmonary infection after liver transplantation. Bacterial infection was the most common followed by fungal infection (13/72, 18.1%), and cytomegalovirus infection (12/72, 16.7%). There were 36 episodes of pulmonary infection caused by one kind of bacteria, 5 episodes by two kinds of bacteria and 6 episodes by multiple kinds of bacteria. Seven episodes of fungal infection were accompanied with bacterial infection, and three episodes of cytomegalovirus infection were accompanied with bacterial infection simultaneously. The 1-, 2- and 3- year survival rates were 71.9%, 61.4%, and 53.4% of the patients with pulmonary infection and 93.1%, 75.8%, and 67.2% of those without the infection. Logistic regression analysis suggested that preoperative infection, mechanical ventilation > 12 hours, a long duration of the operation, total volume of blood transfusion during operation >1000 ml, reoperation after OLT, postoperative pleural effusion and the duration of stay in the intensive care unit were independent risk factors of pulmonary infection after OLT.


CONCLUSIONS
Bacterial infections were the main pulmonary infection after OLT and the infections caused by multiple pathogens or multiple-antibiotic-resistant bacteria were seen more frequently. The risk factors of pulmonary infection should be controlled to decrease the infection rate after OLT. It is important to make a correct diagnosis for pulmonary infection after OLT and use appropriate antibiotics as soon as possible.
Shen
Ying-Hao
YH
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Fan
Jia
J
Zhou
Jian
J
Wu
Zhi-Quan
ZQ
Qiu
Shuang-Jian
SJ
Huang
Xiao-Wu
XW
Sun
Jian
J
Wang
Ting
T
Shi
Ying-Hong
YH
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008171:Lung Diseases / Q000209:etiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult