Background: Pre- and Post-liver transplant infections are a common cause of morbidity and mortality in orthotopic liver transplant (OLT) patients. How pre-transplant infections affect early post-transplant infections, morbidity and mortality remains poorly studied.

Methods: Following IRB approval, the electronic medical records of all OLT patients at Northwestern Memorial Hospital transplanted between 2010 and 2013 were reviewed to identify infections 30 days before and after transplant as well as 1 year patient survival. Key demographic data, lab values, MRSA/VRE colonization status, CMV/EBV exposure, MELD scores, duration of hospitalizations, indications for transplantation, immunosuppression regimens, anti-microbial prophylaxis, infectious disease diagnoses, pathogens, and therapeutic interventions were collected.

Results: To date, data have been abstracted on all patients who underwent OLT in 2012. Of these, 30.4% (24/79) developed 34 episodes of pre-transplant and 29.1% (23/79) developed 31 episodes of post-transplant infections (See Table 1 and 2). Patients with post-transplant infections were more likely to have a pre-transplant infection (52.2% vs. 21.4%, p = 0.0075) and to have a longer pre-transplant (12.9 versus 5.1 days) and post-transplant (18.9 versus 9.1 days) lengths of stay. One-year mortality was higher in patients with pre-transplant (20.8% vs. 3.6%, p = 0.031) and post-transplant (26.1% vs.1.8%, p = 0.0088) infections.

Conclusion: Pre-transplant infection is associated with an increased likelihood of post-transplant infections, longer duration of hospitalization and higher 1-year mortality. Data collection and analyses is ongoing on a larger pool of OLT recipients to identify which pre-transplant infections are associated with the highest risk of post-transplant infection.

CITATION INFORMATION: Ngo S, Levitsky J, Ison M. The Impact of Pre-Transplant Infections on Post-Liver Transplant Outcomes. Am J Transplant. 2016;16 (suppl 3).

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