학술논문
Perfusion fluid‐related infections in liver transplant recipients: A 5‐year, single‐center, retrospective study.
Document Type
Article
Author
Lombardi, Andrea; Renisi, Giulia; Dondossola, Daniele; Palomba, Emanuele; Del Prete, Luca; Viero, Giulia; Zefelippo, Arianna; Azzarà, Cecilia; Maccaro, Angelo; Perali, Carolina; Alagna, Laura; Franchi, Eloisa; Muscatello, Antonio; Gori, Andrea; Grasselli, Giacomo; Donato, Maria Francesca; Matinato, Caterina; Caccamo, Lucio; Antonelli, Barbara; Bandera, Alessandra
Source
Subject
*LIVER transplantation
*PERFUSION
*INFECTIOUS disease transmission
*RETROSPECTIVE studies
*DEATH rate
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Language
ISSN
1398-2273
Abstract
Background: Perfusion fluid (PRF) is employed in liver transplantation (LTx) to maintain graft viability. Still, it represents a new potential way of infection transmission in LTx recipients (LTRs). Currently, no systematic research has investigated this topic. Methods: Five‐year single‐center retrospective study conducted on LTRs from January 2017 to December 2021. We analyzed the incidence of positive PRF culture (PRF+) and perfusion fluid‐related infections (PRF‐RI) and their associated factors. We also assessed 1‐year mortality, both overall and infection‐related. Results: Overall, 234 LTx were included. PRF+ were found in 31/234 (13.2%) LTx for a total of 37 isolates, with >1 isolate identified in 5 (2.1%) cases. High‐risk microorganisms (Enterobacterales 13/37, Enterococcus spp. 4/37, S. aureus 3/37, P. aeruginosa 2/37) were isolated in 25/37 (67.6%) LTRs, the remaining being coagulase‐negative staphylococci (12/37, 32.4%). Antimicrobial prophylaxis was administered to all LTRs, always active against the isolate even if suboptimal in 19 cases (61.3%). PRF‐RI developed in 4/234 LTx (1.7%), and prophylaxis was considered suboptimal in 2/4 of them. The isolation of >1 microorganism in PRF culture was associated with an increased risk of developing PRF‐RI (OR 37.5 [95%CI 2.6–548.4], p =.01). PRF‐RI were associated with longer ICU stays (p =.005) and higher 1‐year mortality, both overall and related to infections (p =.001). Conclusion: Despite PRF+ being infrequent, only a minority of patients develops PRF‐RI. Nonetheless, once occurred, PRF‐RI seems to increase morbidity and mortality rates. [ABSTRACT FROM AUTHOR]