title: The Etiology, Incidence, and Impact of Preservation Fluid Contamination during Liver Transplantation.
abstract: The role of contaminated preservation fluid in the development of infection after liver transplantation has not been fully elucidated. To assess the incidence and etiology of contaminated preservation fluid and determine its impact on the subsequent development of infection after liver transplantation, we prospectively studied 50 consecutive liver transplants, and cultured the following samples in each instance: preservation fluid (immediately before and at the end of the back-table procedure, and just before implantation), blood, and bile from the donor, and ascitic fluid from the recipient. When any culture was positive, blood cultures were obtained and targeted antimicrobial therapy was started. We found that the incidence of contaminated preservation fluid was 92% (46 of 50 cases of liver transplantation per year), but only 28% (14/50) were contaminated by recognized pathogens. Blood and bile cultures from the donor were positive in 28% and 6% respectively, whereas ascitic fluid was positive in 22%. The most frequently isolated microorganisms were coagulase-negative staphylococci. In nine cases, the microorganisms isolated from the preservation fluid concurred with those grown from the donor blood cultures, and in one case, the isolate matched with the one obtained from bile culture. No liver transplant recipient developed an infection due to the transmission of an organism isolated from the preservation fluid. Our findings indicate that contamination of the preservation fluid is frequent in liver transplantation, and it is mainly caused by saprophytic skin flora. Transmission of infection is low, particularly among those recipients given targeted antimicrobial treatment for organisms isolated in the preservation fluid.
authors: Department of Infectious Diseases, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Isabel
authors: http://orcid.org/0000-0001-5542-7878
authors: I
authors: Oriol
authors: Liver Transplant Unit, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Laura
authors: L
authors: Lladó
authors: Liver Transplant Unit, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Marina
authors: M
authors: Vila
authors: Liver Transplant Unit, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Carme
authors: C
authors: Baliellas
authors: Department of Microbiology, Hospital de Bellvitge, Institut d'investigació Biomèdica de Bellvitge, University of Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain.
authors: Fe
authors: F
authors: Tubau
authors: Department of Infectious Diseases, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Núria
authors: N
authors: Sabé
authors: Liver Transplant Unit, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Joan
authors: J
authors: Fabregat
authors: Department of Infectious Diseases, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Jordi
authors: J
authors: Carratalà
mesh_terms: D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology*; D004340:Drug Contamination; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D019188:Organ Preservation Solutions; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D019188:Organ Preservation Solutions