title: Impact of pretransplant infections on clinical outcomes of liver transplant recipients.
abstract: Whether pretransplant nonviral infections influence outcomes after transplantation in liver transplant recipients in the current era is not well defined. One hundred consecutive patients undergoing liver transplantation in 2005-2008 were studied. Demographics, posttransplant clinical events, and mortality were compared between recipients with and without infections within 12 months before transplantation. In all, 32% of the patients (32/100) developed 45 episodes of pretransplant infections, which included spontaneous bacterial peritonitis (35.6%), bloodstream infections (28.9%), cellulitis (13.3%), pneumonia (8.9%), urinary tract infections (6.7%), and other infections (6.7%). Compared with 68 recipients without pretransplant infections, those with infections had a higher Model for End-Stage Liver Disease score and a lower likelihood of transplantation from home and required longer and more frequent hospital care before and after transplantation (P < 0.05). Mortality at 90 (9.4% versus 2.9%) and 180 days (15.6% versus 10.3%) post-transplant did not differ significantly between recipients with and without pretransplant infections (P = not significant). A higher Model for End-Stage Liver Disease score (P < 0.05) and posttransplant infections (P < 0.05 and P < 0.001), but not pretransplant infections, were associated with posttransplant mortality at 90 and 180 days. In conclusion, pretransplant infections that have been adequately treated do not pose a significant risk for poor outcomes, including posttransplant mortality.
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA.
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Cacciarelli
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000401:mortality*; D002481:Cellulitis / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000401:mortality; D057234:Preoperative Period; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000401:mortality