Epidemiology of Surgical Site Infections After Liver Transplantation: 4 Year Prospective Study.

Y. Natori, R. Kassar, A. Iaboni, S. Hosseini-Moghaddam, D. Vu, S. Husain, E. Renner, C. Rotstein.

Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada.

Meeting: 2016 American Transplant Congress

Abstract number: D115

Keywords: Liver transplantation, Risk factors, Surgical complications

Session Information

Session Name: Poster Session D: Fungi, PJP, Mycobacteria, Infection Risk Factors, Vaccination and Donor Derived Infections

Session Type: Poster Session

Date: Tuesday, June 14, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Introduction

Deceased and living donor liver transplantation (LT) is a lifesaving procedure for individuals with liver failure. However, despite the use of perioperative antibiotic prophylaxis at our center (cefazolin), surgical site infections (SSIs) continue to produce considerable morbidity. This prospective study was undertaken to evaluate the prevalence of SSIs in a cohort of LT recipients and assess the risk factors predisposing patients to these infections.

Methods

This prospective, single center, observational study was conducted in adult patients at the Toronto General Hospital of the University Heath Network, Toronto, ON, Canada from February 2011 to August 2014. SSIs were classified according the Centers for Disease Control classification as superficial, deep and organ/space.

Results

250 adult patients who underwent LT were enrolled. The median recipients age was 56 (range 19-70) years old and 166 (66.4%) patients were males. Sixty nine SSIs were documented in 44 patients (44/250, 17.6%). Organ/space SSIs predominated, accounting for 53 infections (53/69, 76.8%). Nine SSIs (9/69, 13.0%) were superficial, while 7 were deep infections (7/69, 10.1%). Fifty two SSIs (52/69, 75.3%; organ/space 42/53, 79.2%; deep 5/7, 71.4%; superficial 4/9 44.4%) were due to cefazolin resistant organisms. Factors predictive of SSIs in the multivariate analysis were duct to duct anastomosis (OR 3.20, p=0.012) and a trend for vasopressor use (p=0.09).

Conclusion

SSIs caused by organ/space infections remain a serious and common complication after LT. Although cefazolin is the perioperative prophylaxis employed, it had little activity against the pathogens causing SSIs particularly organ/space ones. Only duct to duct anastomosis that is associated with a greater risk of postoperative leakage was an independent risk factor predicting SSI in our multivariate analysis. Appropriate perioperative prophylaxis targeting duct to duct anastomosis and potential pathogens causing SSIs in LT patients is warranted.

CITATION INFORMATION: Natori Y, Kassar R, Iaboni A, Hosseini-Moghaddam S, Vu D, Husain S, Renner E, Rotstein C. Epidemiology of Surgical Site Infections After Liver Transplantation: 4 Year Prospective Study. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Natori Y, Kassar R, Iaboni A, Hosseini-Moghaddam S, Vu D, Husain S, Renner E, Rotstein C. Epidemiology of Surgical Site Infections After Liver Transplantation: 4 Year Prospective Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/epidemiology-of-surgical-site-infections-after-liver-transplantation-4-year-prospective-study/. Accessed November 22, 2024.

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