The purpose of this study was to describe the bacteremia transmission rate of transplanting livers from donors with positive bacterial blood cultures into liver transplant recipients. Secondary objectives were to describe organ function, reoperation, and mortality outcomes and to assess the efficacy of antimicrobial prophylaxis in recipients of a liver from a bacteremic organ donor.

This single-institution retrospective study included adult liver transplant recipients from a donor with a positive bacterial blood culture between 2010 and 2016. Patients were required to have at least one year of follow up and excluded if they had an identified bacterial infection at the time of transplant, multi-organ transplant, or pregnancy. Patients were matched to a control group by MELD score in a 1:3 ratio. The primary endpoint was incidence of bacterial transmission. Secondary endpoints included duration of antibiotic prophylaxis, incidence of vasopressor use, duration of mechanical ventilation, ICU length of stay, and incidence of reoperation, graft loss, and mortality.

Twenty-two patients met inclusion criteria and were matched to 66 control patients with an average MELD score of 25. The study patients were mostly male (71.2%) and Caucasian (68.2%). There were no differences in baseline characteristics of gender, age, race, or PHS increased risk criteria. Nineteen patients received livers from donors with gram-positive bacteremia identified and three with gram-negative bacteremia. Surveillance blood cultures were drawn for 13/22 patients and transmission did not occur in any of these patients. There was no difference in any secondary endpoint.

Bacteremia transmission was not observed in any patient in this study, despite shorter than recommended durations of prophylactic antibiotics. We conclude that a shorter duration of targeted antibiotic prophylaxis may be adequate in preventing transmission.

CITATION INFORMATION: Bley D., Lo D., Lyon III G., Subramanian R., Todd S. Impact of Positive Donor Blood Cultures in Liver Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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