Infection in liver transplant recipients--analysis of 68 cases at teaching hospital in Taiwan

Abstract

Background: In Taiwan, liver transplantation is a common treatment of end-stage liver diseases. Infection has a negative impact on the survival of these patients and their grafts. We evaluated the timing and frequency of infections, and the risk factors associated with infection and mortality in liver transplant recipients from Taiwan.

Methods: This retrospective study enrolled all adult patients who underwent orthotopic liver transplantation from January 2004 to November 2008 at a tertiary hospital in Taiwan.

Results: Sixty-eight patients were enrolled (male/female = 46/22) and average age was 51.3 years. Bacterial infection (26/68, 38.2%) was the most common infectious disease, with a rate of 0.3/1,000 person-days in the perioperative period, 0.27/1,000 person-days in the early operative period, and 0.38/1,000 person-days in the late-operative period. Operation-related complications increased the risk of bacterial infection. Biliary stricture was the most common operation-related complication, and this was associated with biliary tract infection (p < 0.001). The average time from first stent placement for biliary stricture by endoscopic retrograde cholangiography to biliary tract infection was 34.5 days. The overall mortality rate was 11.7%, and the mortality rate was 14% for patients with infections.

Conclusions: Bacterial infection was the most common type of infection in liver transplant recipients. Surgery-related complication, especially biliary tract stricture was risk factor for infection. We suggest that the current recommendations about the timing of endoscopic retrograde cholangiography intervention be reevaluated.