Tuesday July 03, 2018 from 16:30 to 17:30
The Risk Factors of Post-Transplant Bacteremia in Living Donor Liver Transplantation
Masahiko Kubo1, Kunihito Gotoh1, Hidetoshi Eguchi1, Yoshifumi Iwagumi1, Daisaku Yamada1, Tadafumi Asaoka1, Takehiro Noda1, Koichi Kawamoto1, Shogo Kobayashi1, Koji Umeshita1, Yuichiro Doki1, Masaki Mori1.
1Gastroenterological Surgery, Osaka University, Suita City, Japan
Background: Infectious complications such as bacteremia after living donor liver transplantation (LDLT) are known as the influence for morbidity and mortality. However, the risk factors of post-transplant bacteremia remain unclear. Objective: The aim was to evaluatethe risk factors for post-transplant bacteremia.
Patients and Methods: We retrospectively analyzed the frequency and characteristics of post-transplant bacteremia in 118 adult LDLT recipients between march 1999 and December 2012 at Osaka University. The mean age of recipients was 49±12 years old, and that of donors was 39±13 years old. 41 of 118 recipients (34.7%) had episodes of post-transplant bacteremia. We evaluated relation between post-transplant bacteremia and outcomes. Furthermore, we analyzed the risk factors of post-transplant bacteremia. Results: 5-year survival rate was no significant difference in recipients between with and without bacteremia (n = 118; 75.2% versus 84.4%, respectively, P =0.19). In subgroup analysis, we defined recipients <41 as younger group, and recipients ≥41 as older group. Younger group included 24 recipients (20.3%), and older group did 94 recipients (79.6%). Recipients of post-transplant bacteremia were 7 of 24 in younger group (29.2%), and 34 of 94 in older group (36.2%). In younger group, 5-year survival rate of recipients with bacteremia was significantly lower than that of recipients without bacteremia (n = 24; 57.1% versus 94.1%, respectively, P =0.034). On the other hand, in older group, there was no significant difference of 5-year survival rate in recipients between with and without bacteremia (n = 94; 79.0% versus 81.7%, respectively, P=0.66). Univariate and multivariate analysis showed that blood loss in surgery (≥5100ml, P = 0.0067) and older donor age (≥49 years old, P = 0.020) were independent risk factors for post-transplant bacteremia in younger group.
Conclusion: Especially careful management of infections could be crucial for improving the outcome of LDLT using older donor in younger recipients.