Infections in liver transplantation: risk factors and strategies for prevention

J Hosp Infect. 1995 Jun:30 Suppl:209-17. doi: 10.1016/0195-6701(95)90021-7.

Abstract

Infection affects up to 70% of liver transplant recipients and is the second most common complication after rejection and graft dysfunction. Identified risk factors for infection include: previous transplantation; type of biliary anastomosis; transfusion requirements at surgery; surgical complications; duration of operation; duration of postoperative ventilation; serological status of donor and recipient; steroid use and serotherapy for rejection; and pre- and post-transplant antibiotic usage. The majority of symptomatic infections are bacterial and relate to surgery (intra-abdominal, biliary and wound infections), ventilation and intravenous cannulae. Cytomegalovirus infections occur in 45-100% of recipients but are asymptomatic in the majority. Fungal infections are mostly due to Candida albicans but infections due to Aspergillus spp. occur in approximately 6% and carry a high mortality. There are very few prospective comparative trials of antimicrobial prophylaxis in this patient population. The management of these patients needs to be based on such studies.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / prevention & control*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Intraoperative Care
  • Liver Transplantation*
  • Mycoses / prevention & control
  • Risk Factors
  • Virus Diseases / prevention & control

Substances

  • Anti-Bacterial Agents
  • Immunosuppressive Agents