Pattern of Infection After Pediatric Liver Transplant and Its Associated Risk Factors

Document Type

Article

Publication Date

2-1-2025

Abstract

BackgroundLiver transplantation has improved survival rates in pediatric patients with end-stage liver failure. However, post-liver transplant infection remains a threat to patient recovery. This study reported the frequency and patterns of infections after liver transplantation and identified factors related to the accuracy of fever source investigation.MethodThis is a single-center descriptive and retrospective study in the quaternary Pediatric Intensive Care Unit (PICU) in Japan. All pediatric patients who underwent liver transplantation from 2019 to 2021 were eligible. The patients were divided into two groups based on culture positivity: the positive culture group and the negative culture group.ResultsA total of 152 pediatric patients were included in the study. The median age was 11 months, and 86% of cases underwent living donor liver transplantation. Among the 152 cases, 18% showed positive bacterial culture results. The timing of positive culture varied bimodally, with 34% occurring after postoperative day 15. Among the positive cultures, 84% were bacterial, and 20% were fungal. Factors associated with positive culture were analyzed, and as a result, re-laparotomy and a higher graft recipient weight ratio (GRWR) were identified as factors associated with infection.ConclusionsWe reported the frequency and patterns of infections in pediatric patients undergoing living donor liver transplantation and demonstrated that factors associated with positive culture were re-laparotomy and GRWR. This study provides important clinical data for infection management after liver transplantation.

Keywords

graft recipient weight ratio, infection, liver transplantation, re-laparotomy

Divisions

ummc

Publication Title

Pediatric Transplantation

Volume

29

Issue

1

Publisher

Wiley

Publisher Location

111 RIVER ST, HOBOKEN 07030-5774, NJ USA

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