Pre- and post-transplant bacterial infections in liver transplant recipients

Madeleine R. Heldman, Stephen Ngo, Peter B. Dorschner, Mia Helfrich, Michael G Ison*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Early (<1 month) bacterial infection after liver transplant is a major cause of morbidity and mortality among liver transplant recipients. We investigated the impact of pre-transplant bacterial infection on early post-transplant bacterial infection incidence and outcomes. Methods: A retrospective cohort study identified all patients who underwent liver transplantation between January 1, 2011, and December 31, 2012, at a single tertiary center in the United States. Infections occurring within the 30 days prior to transplant and within the 30 following transplant were identified. Information regarding pre-transplant morbidity and post-transplant outcomes was collected. Results: One-hundred seventy-four patients were included in the study. Forty patients (23%) experienced a total of 50 pre-transplant infections. Fifty-two (30%) developed a total of 62 post-transplant infections. Patients with a pre-transplant infection were more likely to develop a post-transplant infection compared to patients without a pre-transplant infection (48% [19 of 40] vs. 25% [33 of 134], respectively, P =.006). Patients with a pre-transplant infection had a longer mean post-transplant length of stay compared to those without a pre-transplant infection (16.3 days vs. 10.4 days, respectively, P <.001), but survival at 30 days was similar in both groups (95% [38 of 40] vs. 97% [130 of 134, respectively, P =.56). Conclusions: Among liver transplant recipients, pre-transplant infection is an important risk factor for early post-transplant bacterial infections. Pre-transplant infection is associated with increased early morbidity but not mortality after transplant.

Original languageEnglish (US)
Article numbere13152
JournalTransplant Infectious Disease
Volume21
Issue number5
DOIs
StatePublished - Oct 1 2019

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Bacterial Infections
Transplants
Liver
Infection
Transplant Recipients
Morbidity
Mortality
Liver Transplantation

Keywords

  • bacterial infection
  • liver transplant

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

Cite this

Heldman, Madeleine R. ; Ngo, Stephen ; Dorschner, Peter B. ; Helfrich, Mia ; Ison, Michael G. / Pre- and post-transplant bacterial infections in liver transplant recipients. In: Transplant Infectious Disease. 2019 ; Vol. 21, No. 5.
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abstract = "Background: Early (<1 month) bacterial infection after liver transplant is a major cause of morbidity and mortality among liver transplant recipients. We investigated the impact of pre-transplant bacterial infection on early post-transplant bacterial infection incidence and outcomes. Methods: A retrospective cohort study identified all patients who underwent liver transplantation between January 1, 2011, and December 31, 2012, at a single tertiary center in the United States. Infections occurring within the 30 days prior to transplant and within the 30 following transplant were identified. Information regarding pre-transplant morbidity and post-transplant outcomes was collected. Results: One-hundred seventy-four patients were included in the study. Forty patients (23{\%}) experienced a total of 50 pre-transplant infections. Fifty-two (30{\%}) developed a total of 62 post-transplant infections. Patients with a pre-transplant infection were more likely to develop a post-transplant infection compared to patients without a pre-transplant infection (48{\%} [19 of 40] vs. 25{\%} [33 of 134], respectively, P =.006). Patients with a pre-transplant infection had a longer mean post-transplant length of stay compared to those without a pre-transplant infection (16.3 days vs. 10.4 days, respectively, P <.001), but survival at 30 days was similar in both groups (95{\%} [38 of 40] vs. 97{\%} [130 of 134, respectively, P =.56). Conclusions: Among liver transplant recipients, pre-transplant infection is an important risk factor for early post-transplant bacterial infections. Pre-transplant infection is associated with increased early morbidity but not mortality after transplant.",
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Pre- and post-transplant bacterial infections in liver transplant recipients. / Heldman, Madeleine R.; Ngo, Stephen; Dorschner, Peter B.; Helfrich, Mia; Ison, Michael G.

In: Transplant Infectious Disease, Vol. 21, No. 5, e13152, 01.10.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pre- and post-transplant bacterial infections in liver transplant recipients

AU - Heldman, Madeleine R.

AU - Ngo, Stephen

AU - Dorschner, Peter B.

AU - Helfrich, Mia

AU - Ison, Michael G

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: Early (<1 month) bacterial infection after liver transplant is a major cause of morbidity and mortality among liver transplant recipients. We investigated the impact of pre-transplant bacterial infection on early post-transplant bacterial infection incidence and outcomes. Methods: A retrospective cohort study identified all patients who underwent liver transplantation between January 1, 2011, and December 31, 2012, at a single tertiary center in the United States. Infections occurring within the 30 days prior to transplant and within the 30 following transplant were identified. Information regarding pre-transplant morbidity and post-transplant outcomes was collected. Results: One-hundred seventy-four patients were included in the study. Forty patients (23%) experienced a total of 50 pre-transplant infections. Fifty-two (30%) developed a total of 62 post-transplant infections. Patients with a pre-transplant infection were more likely to develop a post-transplant infection compared to patients without a pre-transplant infection (48% [19 of 40] vs. 25% [33 of 134], respectively, P =.006). Patients with a pre-transplant infection had a longer mean post-transplant length of stay compared to those without a pre-transplant infection (16.3 days vs. 10.4 days, respectively, P <.001), but survival at 30 days was similar in both groups (95% [38 of 40] vs. 97% [130 of 134, respectively, P =.56). Conclusions: Among liver transplant recipients, pre-transplant infection is an important risk factor for early post-transplant bacterial infections. Pre-transplant infection is associated with increased early morbidity but not mortality after transplant.

AB - Background: Early (<1 month) bacterial infection after liver transplant is a major cause of morbidity and mortality among liver transplant recipients. We investigated the impact of pre-transplant bacterial infection on early post-transplant bacterial infection incidence and outcomes. Methods: A retrospective cohort study identified all patients who underwent liver transplantation between January 1, 2011, and December 31, 2012, at a single tertiary center in the United States. Infections occurring within the 30 days prior to transplant and within the 30 following transplant were identified. Information regarding pre-transplant morbidity and post-transplant outcomes was collected. Results: One-hundred seventy-four patients were included in the study. Forty patients (23%) experienced a total of 50 pre-transplant infections. Fifty-two (30%) developed a total of 62 post-transplant infections. Patients with a pre-transplant infection were more likely to develop a post-transplant infection compared to patients without a pre-transplant infection (48% [19 of 40] vs. 25% [33 of 134], respectively, P =.006). Patients with a pre-transplant infection had a longer mean post-transplant length of stay compared to those without a pre-transplant infection (16.3 days vs. 10.4 days, respectively, P <.001), but survival at 30 days was similar in both groups (95% [38 of 40] vs. 97% [130 of 134, respectively, P =.56). Conclusions: Among liver transplant recipients, pre-transplant infection is an important risk factor for early post-transplant bacterial infections. Pre-transplant infection is associated with increased early morbidity but not mortality after transplant.

KW - bacterial infection

KW - liver transplant

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