Risk factors and prediction of bacterial complications in liver transplantation

Aim. To conduct a systems analysis of clinical and epidemiological risk factors of bacterial complications associated with liver transplantation, to evaluate the effectiveness of their prevention algorithm.

Materials and methods. The authors analyzed the treatment outcomes of 1000 recipients who underwent liver transplantation from April 2008 to April 2023. The study involved analysis of correlation between infections associated with health care and main risk factors, including contamination of different loci and preservation solution.

Results. The incidence of healthcare-associated infections accounted for 22.2%. The cumulative incidence of donor organ and recipient contamination was 9.85%. Transmission of infection occurred in 29% of cases. Sepsis developed in 8% of all recipients with healthcare-associated infection. The mortality rate was 70% in cases of sepsis. After liver transplantation, in-hospital mortality was 9.3%. Urgent transplantation was required in 10.7% of observations. Univariate regression analysis shows the highest risk contribution to healthcare-associated infection for the MELD score, contamination of preservation solution with multidrug-resistant flora, severe early graft dysfunction, blood loss, and warm ischemia time.

Conclusion. Contamination of preservation solution increases the risk of bacterial complications associated with liver transplantation. The resistance profile affects the development time, structure and outcome of these complications. Timely diagnosis and infection control measures are fundamental to preventing the infectious complications.

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