*Purpose: Infections are common cause of morbidity and mortality post liver transplant (LT). Risk factors are related to donor and recipient factors, including cold ischemia time (CIT), high MELD score, CMV status (D+/R-), prolonged hospitalization, repeat operations, malnutrition and rejections. With recent advancements in management of these patients, there is a lack of data to determine if there is a change in patterns of risk factors over time. This study will evaluate risk factors associated with developing infections post LT over a 16-year period.

*Methods: Single-center retrospective analysis of LT recipients transplanted over 16 years. All were followed for 1-yr post-transplant and were considered if they were first-time LT recipients and received immunosuppressive regimen of Tac, MMF and steroids (tapered off by 3-months). All patients received the same antibiotic regimen through the time period. Only culture positive infections (bacterial, viral, and fungal) were evaluated.

*Results: 1202 patients were evaluated and categorized into 2 groups; Era 1 (E1), patients transplanted 2000-2009 (n=719) and Era 2 (E2), patients transplanted 2010-2016 (n=483). Patients >45 yrs had more infections in E2 than E1 [E1: 334 (54.9%); E2: 268 (62.0%); p<0.05], while those <44 yrs showed no difference. Gender was similar between groups, however, females in E1 [M: 253 (52.9%); F: 151 (62.7%); p<0.05] and E2 [M: 170 (57.8%); F: 128 (67.7%); p<0.05] developed more infections than males. Etiology of HCV alone or with EtOH developed more infections in E2 than E1 [E1: 111 (54.7); E2: 77 (68.1), p<0.05]. Patients had similar median MELD scores, hospital length of stay, albumin (g/dL) and CMV mismatches. Patients in E2 developed more infections than E1 [E1: 404 (56.2%); E2: 298 (61.7%); p=0.05] and risk factors were analyzed below.

*Conclusions: Our data shows that the risks for infections post liver transplant has changed over time. The CIT, rejections, and patients who returned to OR showed a statistical decrease in E2 compared to E1, despite the other risk factors being similar or decreased, the number of infections has decreased significant in recent years. More studies need to be done to examine the factors that could account for the discrepancy.

« Back to 2020 American Transplant Congress