Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients.
OBJECTIVE
Bacteremia is a major infectious complication associated with mortality in liver transplant recipients. The causative organisms and clinical courses differ between medical centers due to variations in regional bacterial epidemiology and posttransplant care. Further, living donors in Korea contribute to 83% of liver transplants, and individualized data are required to improve survival rates.


METHODS
We retrospectively analyzed 104 subjects who had undergone living-donor liver transplant from 2005 to 2007.


RESULTS
Among the 144 consecutive living-donor liver transplant recipients, 24% (34/144) developed bacteremia, 32% (46/144) developed non-bacteremic infections, and 44% (64/144) did not develop any infectious complications. Forty episodes of bacteremia occurred in 34 recipients. The major sources of bacteremia were intravascular catheter (30%; 12/40), biliary tract (30%; 12/40), and abdomen (22.5%; 9/40). Gram-positive cocci were more common (57.5%; 23/40) than Gram-negative rods (32.5 %; 13/40) and fungi (10%; 4/40). The data revealed that the following factors were significantly different between the bacteremia, non-bacteremic infection, and no infection groups: age (p = 0.024), posttransplant hemodialysis (p = 0.002), ICU stay (p = 0.012), posttransplant hospitalization (p < 0.0001), and duration of catheterization (p < 0.0001). The risk factors for bacteremia were older than 55 years (odds ratio, 6.1; p = 0.003), catheterization for more than 22 days (odds ratio, 4.0; p = 0.009), UNOS class IIA (odds ratio, 6.6; p = 0.039), and posttransplant hemodialysis (odds ratio, 23.1; p = 0.001). One-year survival rates in the bacteremic, non-bacteremic infection, and no infection groups were 73.2%, 91.3%, and 93.5%, respectively.


CONCLUSIONS
Early catheter removal and preservation of renal function should focus for improving survival after transplant.
Kim
Sang Il
SI
Department of Internal Medicine, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kim
Youn Jeong
YJ
Jun
Yoon Hee
YH
Wie
Seong Heon
SH
Kim
Yang Ree
YR
Choi
Jong Young
JY
Yoon
Seung Kyu
SK
Moon
In Sung
IS
Kim
Dong Goo
DG
Lee
Myung Duk
MD
Kang
Moon Won
MW
D000328:Adult; D016470:Bacteremia / Q000209:etiology / Q000401:mortality*; D002404:Catheterization / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D016031:Liver Transplantation / Q000401:mortality* / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016019:Survival Analysis