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Takanobu Hara, Akihiko Soyama, Mitsuhisa Takatsuki, Masaaki Hidaka, Izumi Carpenter, Ayaka Kinoshita, Tomohiko Adachi, Amane Kitasato, Tamotsu Kuroki, Susumu Eguchi
(Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan)
Ann Transplant 2014; 19:674-679
The impact of treated preoperative bacterial infections on the outcome of living-donor liver transplantation (LDLT) is not well defined. The aim of this study was to determine the frequency of pre-transplant bacterial infections within one month before LDLT and their impact on the post-transplant morbidity and mortality.
Material and Methods: We retrospectively reviewed the records of 50 adult LDLT recipients between January 2009 and October 2011. Patients were divided into two groups based on whether they had episodes of bacterial infections within one month before LDLT.
Results: There were 20 patients who required antimicrobial therapy for pre-transplant infections. The pre-transplant infections comprised urinary tract infections (35%), cholangitis (10%), pneumonia (10%), bacteremia (5%), spontaneous bacterial peritonitis (5%), acute sinusitis (5%), subcutaneous abscess (5%), and empirical treatment (25%). Patients with pre-transplant infections had higher Child-Pugh scores [median, 11 vs. 9.5, P<0.05] and model for end-stage liver disease scores [median, 17.5 vs. 14, P<0.05] compared with the other patients. There were no correlations between the pathogens involved in the pre-transplant infections and those involved in post-transplant infections. The incidence of post-transplant infections was higher in the pre-transplant infection group within one week after LDLT, but was almost the same within one month after LDLT. The one-year survival rates were not significantly different between the groups.
Conclusions: Although pre-transplant infections are associated with a high risk of postoperative bacterial infection shortly after LDLT, they did not affect the short-term outcome when they had been appropriately treated before transplantation.
Keywords: Bacterial Infections, Liver Transplantation, Living Donors, Perioperative Care