Liver Transplantation and Early Culture Growth: Risk and Impact?

Transplant Proc. 2019 Sep;51(7):2466-2468. doi: 10.1016/j.transproceed.2019.01.169. Epub 2019 Aug 9.

Abstract

Objective: Despite advances in immunosuppressive drugs, postoperative care, and surgical techniques, bacterial infections remain the most important cause of morbidity and mortality in liver transplant patients. The aim of this study is to evaluate the influence of culture results taken on the first day of admission to intensive care unit on mortality, graft rejection, mechanical ventilation duration, and length of intensive care unit stay. Our study has clinical importance because it is the first study evaluating the cultures obtained on the first day of intensive care unit stays in liver transplant patients.

Methods: Patients' demographic data, transplant type, rates of deceased and living donors, culture results, amount of blood and blood products used intraoperatively, previous hospital admission, mortality, incidence of graft rejection, mechanical ventilation duration, and length of intensive care unit stay were recorded.

Results: Mortality and graft rejection were 14.8% and 9%, respectively. The mortality was significantly higher in all 3 cultures and/or in only blood culture-positive patients. Graft rejection, mechanical ventilation duration, and length of intensive care unit stay were significantly higher in patients whose 3 cultures were all positive. Only body mass index had a significant effect on mortality, graft rejection, and positive culture results.

Conclusions: Liver transplant patients' first postoperative day culture results were correlated with mortality, graft rejection, mechanical ventilation duration, and length of intensive care unit stay.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Infections* / complications
  • Bacterial Infections* / diagnosis
  • Child
  • Female
  • Graft Rejection / epidemiology*
  • Graft Rejection / microbiology*
  • Humans
  • Incidence
  • Length of Stay / statistics & numerical data
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / mortality
  • Male
  • Middle Aged
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Young Adult