title: Microbial epidemiology and risk factors of infections in recipients after DCD liver transplantation.
abstract: OBJECTIVE
  Infection is a major cause of increased mortality after a liver transplant (LT). This study sought to identify the incidence, prevalence and risk factors of microbial infection for recipients who underwent LT using grafts from donors after cardiac death (DCD).
  
  
  METHODS
  We retrospectively analysed the frequency and characteristics of post-transplantation infections in 236 recipients who underwent DCD LT between 1 January 2010 and 31 December 2014 in our centre and evaluated the risk factors of post-transplantation infection.
  
  
  RESULTS
  Overall, 162 recipients acquired at least one type of infection during hospitalisation after LT, and the morbidity rate was 68.6%. Moreover, 19 of the 236 recipients died, with an overall mortality rate of 8.1%. In total, 752 pathogens were isolated. Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 26.1% (196), 58.2% (438) and 15.7% (118) of the pathogens, respectively. Kaplan-Meier curves of 1-year survival showed that recipients with infection had a significantly lower cumulative survival rate compared with those without infection (83.2% vs. 90.6%, p < 0.05). Multivariate analysis revealed that age > 60 years (p = 0.010) and severe hepatitis (p = 0.036) were independent risk factors for infection during hospitalisation after LT.
  
  
  CONCLUSIONS
  Infection is a common complication after a DCD-LT that could impair 1-year survival. We suggest physicians pay more attention to the infection of recipients post-LT, especially those recipients greater than 60 years of age and those who suffered from severe hepatitis.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: M-L
authors.initials: ML
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: X-Y
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: M
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: W-L
authors.initials: WL
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou, China.
authors.forename: S-S
authors.initials: SS
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000401:mortality*; D016908:Gram-Positive Bacterial Infections / Q000401:mortality*; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008875:Middle Aged; D009181:Mycoses / Q000401:mortality*; D011183:Postoperative Complications / Q000382:microbiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D066027:Transplant Recipients / Q000706:statistics & numerical data; D055815:Young Adult