title: Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Youn Jeong
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Jun
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Wie
authors.forename: Yang Ree
authors.initials: YR
authors.lastname: Kim
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Seung Kyu
authors.initials: SK
authors.lastname: Yoon
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.forename: Dong Goo
authors.initials: DG
authors.lastname: Kim
authors.forename: Myung Duk
authors.initials: MD
authors.lastname: Lee
authors.forename: Moon Won
authors.initials: MW
authors.lastname: Kang
mesh_terms: 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