Korean J Transplant.  2022 Sep;36(3):203-211. 10.4285/kjt.22.0007.

Infection patterns during the first year after adult liver transplantation: a retrospective analysis

Affiliations
  • 1Department of Nursing, Asan Medical Center, Seoul, Korea
  • 2Department of Clinical Nursing, Graduate School of Industry, University of Ulsan, Ulsan, Korea
  • 3Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 4Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Background
Infection is one of the most significant possible complications after liver transplantation (LT). This study identified patterns of infection and compared the characteristics of patients with and without infections during the first year after LT.
Methods
This retrospective cohort study reviewed adult patients’ electronic medical records to identify infections occurring up to 1 year after LT. The criteria for identifying infections in the first year after LT were either a positive laboratory test or recorded clinical signs or symptoms meeting the accepted criteria for each infection.
Results
The overall incidence of infection during the posttransplant year was 17.3%. The highest infection rate (8.2%) was identified in the first month after LT, with rates of 1.9% and 7.2% at 1–3 months and 3 months to 1 year after LT, respectively. Respiratory tract infections were the most common type of infection, and bacteria were the most common causal agents in the first month post-LT.
Conclusions
It is difficult to compare the posttransplant incidence of infection in the present study with previous studies due to differences in study designs and definitions of infection. This study revealed that respiratory tract infections were the most common type of overall posttransplant infection, especially during the period from 3 months to 1 year after LT.

Keyword

Liver transplantation; Infections; Complications; Morbidity; Mortality

Figure

  • Fig. 1 Flowchart for the selection of study subjects.


Reference

1. Choi JY. 2005; Immune suppression and infection control after transplantation. Clin Mol Hepatol. 11:S99–106.
2. Nah YW, Lee SG, Lee YJ, Park KM, Hwang S, Choi DL, et al. 2001; Infection after adult-to-adult living donor liver transplantation. J Korean Soc Transplant. 15:93–105.
3. Hernandez Mdel P, Martin P, Simkins J. 2015; Infectious complications after liver transplantation. Gastroenterol Hepatol (N Y). 11:741–53.
4. Kim YR. 2006; Infection after liver transplantation. Clin Mol Hepatol. 12:S59–66.
5. Korean Association of Infection Control Nurse (KAICN). 2012. KAICN text of infection control. Hyunmoon Publishing;Seoul:
6. Yoon HK. 2011; Pneumonia in immunocompromised patients. Tuberc Respir Dis. 70:371–83. DOI: 10.4046/trd.2011.70.5.371.
7. Junchen Z, Houjing Z, Yun F. 2016; Cox regression model analysis of infection in renal transplants after operation. Transplant Proc. 48:2678–83. DOI: 10.1016/j.transproceed.2016.08.014. PMID: 27788800.
8. Kim GM, Cheung DY, Kim JI. 2010; Gastrointestinal complication in transplant patients. Korean J Gastrointest Endosc. 41:65–71.
9. Lee SO. 2013; Common infections in solid organ transplant recipients. Korean J Med. 84:145–57. DOI: 10.3904/kjm.2013.84.2.145.
10. Kiriyama S, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Pitt HA, et al. 2013; TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 20:24–34. DOI: 10.1007/s00534-012-0561-3. PMID: 23307001.
11. Korean Association of Infection Control Nurses. 2016. Definition of healthcare associated infections. Korean Association of Infection Control Nurses;Seoul:
12. Korean Dermatological Association. 2014. Textbook of dermatology. 6th ed. Medbook;Seoul:
13. Pfitzmann R, Nüssler NC, Hippler-Benscheidt M, Neuhaus R, Neuhaus P. 2008; Long-term results after liver transplantation. Transpl Int. 21:234–46. DOI: 10.1111/j.1432-2277.2007.00596.x. PMID: 18031464.
14. Kim YJ, Kim SI, Wie SH, Kim YR, Hur JA, Choi JY, et al. 2008; Infectious complications in living-donor liver transplant recipients: a 9-year single-center experience. Transpl Infect Dis. 10:316–24. DOI: 10.1111/j.1399-3062.2008.00315.x. PMID: 18507752.
15. Choi YI, Hwang S, Park GC, Namgoong JM, Jung DH, Song GW, et al. 2013; Clinical outcomes of Pneumocystis carinii pneumonia in adult liver transplant recipients. Transplant Proc. 45:3057–60. DOI: 10.1016/j.transproceed.2013.08.074. PMID: 24157035.
16. Yoon YI, Song GW, Lee SG, Hwang S, Ahn CS, Kim KH, et al. 2012; Analysis of biliary stricture after ABO incompatible adult living donor liver transplantation. J Korean Soc Transplant. 26:277–86. DOI: 10.4285/jkstn.2012.26.4.277.
17. Kim YA, Cho YS, Kim HS, Lee HS, Yi NJ, Lee KW, et al. 2012; Appropriateness of ampicillin/sulbactam as prophylactic antibiotics in liver transplantation. Korean J Clin Pharm. 22:324–9.
18. Vidal E, Torre-Cisneros J, Blanes M, Montejo M, Cervera C, Aguado JM, et al. 2012; Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort. Transpl Infect Dis. 14:595–603. DOI: 10.1111/j.1399-3062.2012.00744.x. PMID: 22650416.
19. van Hoek B, de Rooij BJ, Verspaget HW. 2012; Risk factors for infection after liver transplantation. Best Pract Res Clin Gastroenterol. 26:61–72. DOI: 10.1016/j.bpg.2012.01.004. PMID: 22482526.
20. Cho I, Joo DJ, Kim MS, Yong DE, Huh KH, Choi GH, et al. 2011; Impact of early positive culture results on the short-term outcomes of liver transplants. J Korean Soc Transplant. 25:257–63. DOI: 10.4285/jkstn.2011.25.4.257.
21. Kim SI, Kim YJ, Jun YH, Wie SH, Kim YR, Choi JY, et al. 2009; Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients. Yonsei Med J. 50:112–21. DOI: 10.3349/ymj.2009.50.1.112. PMID: 19259357. PMCID: PMC2649862.
22. Chang MS, Woo JH. 2016; Prevention and treatment of healthcare-associated infections. J Korean Med Assoc. 59:622–8. DOI: 10.5124/jkma.2016.59.8.622.
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