title: Liver biopsy-related infection in liver transplant recipients: A current matter of concern?
abstract: Data from published studies regarding risk factors for liver biopsy (LB)-related infectious complications in liver transplant recipients are inconsistent. We carried out a retrospective cohort study analyzing consecutive LBs for orthotopic liver transplant patients at a tertiary hospital (2001-2011): there were 667 LB procedures (575 percutaneous procedures and 92 transjugular procedures) in 286 liver transplant recipients. There were 20 complications in 19 patients (overall incidence = 3.0%): 10 were infectious complications (8 cases of bacteremia and 2 cases of peritonitis). The causal microorganisms were mainly Pseudomonas aeruginosa (4 patients) and Enterobacteriaceae (4 patients). All complications occurred with biopsies performed in patients hospitalized for more than 48 hours (381 biopsies for 201 patients); hence, only this group was included in the risk factor analysis. The variables associated with the development of infectious complications after LB were the presence of impaired biliary drainage at the time of biopsy (40% versus 15.1%, P = 0.03) and low albumin levels (2.4 versus 3.1 g/dL, P = 0.01). In conclusion, according to our experience, infectious complications secondary to LB in liver transplant recipients are related to hospitalization at the time of biopsy, particularly in the presence of impaired biliary drainage and low albumin levels.
authors.affiliation: Departments of Infectious Diseases, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Cristina López
authors.initials: CL
authors.lastname: Sánchez
authors.forename: Oscar
authors.initials: O
authors.lastname: Len
authors.forename: Joan
authors.initials: J
authors.lastname: Gavalda
authors.forename: Itxarone
authors.initials: I
authors.lastname: Bilbao
authors.forename: Lluis
authors.initials: L
authors.lastname: Castells
authors.forename: Maria Arantzazu
authors.initials: MA
authors.lastname: Gelabert
authors.forename: Helena
authors.initials: H
authors.lastname: Allende
authors.forename: Albert
authors.initials: A
authors.lastname: Pahissa
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D004755:Enterobacteriaceae; D005260:Female; D006470:Hemorrhage; D006760:Hospitalization; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D066027:Transplant Recipients