The Risk Factors of Post-Transplant Bacteremia in Living Donor Liver Transplantation

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Abstract

Background

Infectious complications such as bacteremia after living donor liver transplantation (LDLT) are known as the influence for morbidity and mortality. However, the risk factors of post-transplant bacteremia remain unclear. Objective: The aim was to evaluatethe risk factors for post-transplant bacteremia.

Patients and Methods

We retrospectively analyzed the frequency and characteristics of post-transplant bacteremia in 118 adult LDLT recipients between march 1999 and December 2012 at Osaka University. The mean age of recipients was 49±12 years old, and that of donors was 39±13 years old. 41 of 118 recipients (34.7%) had episodes of post-transplant bacteremia. We evaluated relation between post-transplant bacteremia and outcomes. Furthermore, we analyzed the risk factors of post-transplant bacteremia. Results: 5-year survival rate was no significant difference in recipients between with and without bacteremia (n = 118; 75.2% versus 84.4%, respectively, P =0.19). In subgroup analysis, we defined recipients <41 as younger group, and recipients ≥41 as older group. Younger group included 24 recipients (20.3%), and older group did 94 recipients (79.6%). Recipients of post-transplant bacteremia were 7 of 24 in younger group (29.2%), and 34 of 94 in older group (36.2%). In younger group, 5-year survival rate of recipients with bacteremia was significantly lower than that of recipients without bacteremia (n = 24; 57.1% versus 94.1%, respectively, P =0.034). On the other hand, in older group, there was no significant difference of 5-year survival rate in recipients between with and without bacteremia (n = 94; 79.0% versus 81.7%, respectively, P=0.66). Univariate and multivariate analysis showed that blood loss in surgery (≥5100ml, P = 0.0067) and older donor age (≥49 years old, P = 0.020) were independent risk factors for post-transplant bacteremia in younger group.

Conclusion

Especially careful management of infections could be crucial for improving the outcome of LDLT using older donor in younger recipients.

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