Transpl Infect Dis. 2021 Jun 21:e13673. doi: 10.1111/tid.13673. Online ahead of print.
ABSTRACT
BACKGROUND: Infections post-liver transplantation are major drivers for morbidity and mortality. However, the impact of infections within 180 days post-liver transplantation on long-term survival is not clear.
METHODS: We present a retrospective cohort of 317 liver transplant patients for whom all infectious episodes were prospectively collected during a mean follow-up of 4.4 years.
RESULTS: 143/317 (45%) of patients suffered from any infectious episode during the first six months following liver transplantation. Patients with surgical site infections had a reduced survival compared to those with no infection (HR 0.33, 95% CI 0.172-0.636, p=0.001), whereas infections from other sources, including pneumonia, UTI, and line-related infections were not associated with increased mortality. Furthermore, even though the presence of any infection within 30 days or six months post-transplantation did not affect survival, more than a single infectious episode per patient was significantly associated with increased mortality (HR 1.70, CI 1.12- 2.60, p=0.013). In a multivariate analysis, the number of infectious episodes remained statistically significant (HR 1.58, 95% CI 1.03-2.43, p=0.035) upon adjustment for other major variables associated with comorbidities and infection risk.
CONCLUSIONS: Surgical site infections and the number of infectious episodes within 180 days post-liver transplantation are major determinants of long-term survival among these patients.
PMID:34153169 | DOI:10.1111/tid.13673
