title: Incidence, pattern and clinical relevance of microbial contamination of preservation fluid in liver transplantation.
abstract: BACKGROUND
  Transmission of pathogens via preservation fluid (PF) is a potential cause of infection among liver transplant recipients. Here, we evaluated the incidence and pattern of microbial contamination of PF and its impact on postoperative graft function after liver transplantation.
  
  
  METHODS
  This longitudinal study included data from 41 primary liver transplantations and 5 re-transplantations performed between December 2010 and September 2011. Results of microbiological analyses of 92 PF samples collected before and after the back-table procedure were evaluated in order to establish the incidence and pattern of contamination. The impact of positive PF cultures on early graft function and rate of pathogen transmission was assessed. Post-transplant antibiotic protocol was based on piperacillin/tazobactam administration for a minimum of 10 days.
  
  
  RESULTS
  The incidence of contamination was 84.8% (39/46), both for samples collected before and after the back-table procedure. Gram-positive low-virulence organisms typical for superficial saprophytic flora, mainly coagulase-negative staphylococci, were predominant. There were no cases of pathogen transmission from PF to the recipient. Positive cultures of PF samples obtained after the back-table procedure were associated with significant elevation of aspartate (p=0.034) and alanine aminotransferase (p=0.048) on the first 5 postoperative days. No significant differences were found regarding serum bilirubin concentration (p=0.335) and international normalized ratio (p=0.137).
  
  
  CONCLUSIONS
  Despite high incidence of PF contamination, infections caused by pathogens isolated from PF were not observed. However, presence of pathogens in PF might lead to temporary impairment of graft function.
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. michal.grat@gmail.com
authors.forename: Michał
authors.initials: M
authors.lastname: Grąt
authors.forename: Joanna
authors.initials: J
authors.lastname: Ligocka
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Lewandowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Barski
authors.forename: Wacław
authors.initials: W
authors.lastname: Hołówko
authors.forename: Michał
authors.initials: M
authors.lastname: Skalski
authors.forename: Oskar
authors.initials: O
authors.lastname: Kornasiewicz
authors.forename: Paulina
authors.initials: P
authors.lastname: Usarek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zieniewicz
authors.forename: Grażyna
authors.initials: G
authors.lastname: Młynarczyk
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D004340:Drug Contamination / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008137:Longitudinal Studies; D019188:Organ Preservation Solutions; D013210:Staphylococcus / Q000302:isolation & purification*
chemical_list: D019188:Organ Preservation Solutions