title: Infectious complications in pediatric liver transplantation candidates.
abstract: We analyzed infections that occurred within one month prior to LT, identified factors associated with their occurrence and effect of infections on post-transplant mortality. The study group included 40 consecutive children who underwent LT. Sites and types of infection and culture results were recorded prospectively. IID was assessed. Risk factors for the infectious events were analyzed. Forty infection episodes were found in 24 patients (60%); 90% were bacterial, 7.5% fungal, and 2.5% viral. Overall, IID was 38.2 per 1000 patient days. Sites of bacterial infection were urinary tract in 13 events (36.1%) and blood stream in 11 events (30.5%). Bacteremia (culture positive infection episodes) was identified in 19 events (52.7%). Gram-negative isolates were twice as frequent as Gram-positive infections (63.1% vs. 36.9%). Risk factors for the infectious complications were young age, low body weight, prior abdominal surgery, chronic liver disease related to biliary problems, presence of ascites, portal hypertension and cirrhosis, and high PELD score (p < 0.05 for all). Infectious complications in pediatric LT candidates are common. Preventive measures are important not only to reduce the infectious complications but also to prevent the post-operative mortality.
authors.affiliation: Faculty of Medicine, Department of Pediatric Gastroenterology, Ege University, Bornova, Izmir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Cakir
authors.forename: Cigdem
authors.initials: C
authors.lastname: Arikan
authors.forename: Sezin Asik
authors.initials: SA
authors.lastname: Akman
authors.forename: Masallah
authors.initials: M
authors.lastname: Baran
authors.forename: Eylem Ulas
authors.initials: EU
authors.lastname: Saz
authors.forename: Ulas Eylem
authors.initials: UE
authors.lastname: Saz
authors.forename: Rasit Vural
authors.initials: RV
authors.lastname: Yagci
authors.forename: Murat
authors.initials: M
authors.lastname: Zeytunlu
authors.forename: Murat
authors.initials: M
authors.lastname: Kilic
authors.forename: Sema
authors.initials: S
authors.lastname: Aydogdu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D014421:Turkey / Q000453:epidemiology