Background: Clostridium Difficile infection (CDI) is a growing problem in hospitalized patients and occurs in liver transplant recipients at a higher rate than non-transplant patients. Methods: We performed a retrospective analyses of CDI as determined by PCR in all liver transplant recipients at a single institution between 2010 and 2017 (n=545). Results: The overall incidence of CDI was 17.8% in liver transplant patients. When analyzed by infections per admission, liver recipients were more likely to acquire C Diff than other hospitalized patients at our institution (8.2% vs 1.6%). 82% of CDI occurred with 1 year of transplant and the median time to infections was 85 days. When comparing patients who acquired C Diff to those without infection, there were no significant differences in age, sex, donor risk index, or MELD score at the time of transplant. However, C Diff positive patients were more likely to have required dialysis after transplant (33% vs 16%, Chi-square <0.001), and were more likely to have been hospitalized at the time of transplant (50% vs 35%, Chi-square =0.05). Interestingly, the overall survival rate of C. Diff infected patients is significantly reduced compared to uninfected recipients when performing Kaplan-Meier analysis (p<0.02). This difference in mortality held true even if patient's requiring dialysis were excluded from the analysis. Conclusion: C Diff infection leads to an increase in mortality which manifests 3 years after transplant, even though most infections occur within the first year.

CITATION INFORMATION: Ahearn A., Mahboub P., Theodoropoulos N., Movahedi B., Martins P., Campion M., Nathan R., Bozorgzadeh A. Clostridium Difficile Infection after Liver Transplant is Associated with Poor Long-Term Survival Am J Transplant. 2017;17 (suppl 3).

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