title: The risk factors for early infection in adult living donor liver transplantation recipients.
abstract: OBJECTIVE
  The high rate of early major infections in liver transplantation recipients is due to their compromised immune-system. We examined the risk factors of early major infection in living donor liver transplantation (LDLT).
  
  
  METHODS
  From January 2004 to December 2010, 242 patients undergoing LDLT were enrolled in the prospective cohort. We prospectively collected their clinical and demographic variables, operative details, and posttransplant complications.
  
  
  RESULTS
  One hundred thirty-nine patients (57.7%) experienced 252 episodes of early infection posttransplantation: bloodstream septicemia (n = 46, 18.3%), urinary tract (n = 34; 14.1%), pneumonia (n = 64; 25.4%), peritonitis (n = 62; 25.7%), and catheter related (n = 46; 19%). The most frequent Gram-positive bacteria were coagulase-negative staphylococci (n = 52; 16.9%), followed by Staphylococcus aureus (n = 32; 10.4%). The most common Gram-negative bacteria were Escherichia coli (n = 27; 8.8%); Acinetobacter baumannii (n = 29; 9.4%), Pseudomonas aureos (n = 18; 5.8%), and Sternotrophomonas maltophilia (n = 18; 5.8%). Upon multivariate logistic regression analysis, the risk factors for early major infection were a high creatinine level (odds ratio = 1.481), a long anhepatic arterial phase (1.01), a reoperation (6.417), young age (1.040), and non-hepatocellular carcinoma recipient (2.141).
  
  
  CONCLUSIONS
  Early major infection after LDLT was high with Gram-positive bacteria, the most common etiologies. Prolonged anhepatic arterial phase, renal insufficiency, and reoperation were risk factors for an early major infection.
authors.affiliation: Chang-Gung Transplantation Institute, Department of General Surgery, Chang-Gung Memorial Hospital at Linkou, Chang-Gung University, College of Medicine, Taoyuan, Taiwan.
authors.forename: R-S
authors.initials: RS
authors.lastname: Soong
authors.forename: K-M
authors.initials: KM
authors.lastname: Chan
authors.forename: H-S
authors.initials: HS
authors.lastname: Chou
authors.forename: T-J
authors.initials: TJ
authors.lastname: Wu
authors.forename: C-F
authors.initials: CF
authors.lastname: Lee
authors.forename: T-H
authors.initials: TH
authors.lastname: Wu
authors.forename: W-C
authors.initials: WC
authors.lastname: Lee
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D011446:Prospective Studies; D012307:Risk Factors