Risk Factors for Bloodstream Infection After Living-donor Liver Transplantation in Children

Overview

Journal Pediatr Infect Dis J

Specialty Pediatrics

Date 2015 Jun 30

PMID 26121201

Citations 13

Authors

Kensuke Shoji

Takanori Funaki

Mureo Kasahara

Seisuke Sakamoto

Akinari Fukuda

Florin Vaida

Kenta Ito

Isao Miyairi

Akihiko Saitoh

Affiliations

Soon will be listed here.

Abstract

Background: Postoperative bloodstream infection (BSI) is the most important determinant of recipient morbidity and mortality after liver transplantation (LT). Children who underwent LT are at the highest risk of developing BSI because of the significant surgical intervention, use of multiple devices, and administration of immunosuppressive agents. However, information regarding the risk factors for BSI in children after LT is limited.

Methods: We retrospectively reviewed 210 children who underwent living-donor LT at the largest pediatric LT center in Japan. Patients' characteristics, blood culture results and clinical outcomes were extracted from electronic medical records. Univariate and multivariate analyses were performed to identify the risk factors for BSI.

Results: Among the 210 LT recipients, 53 (25%) recipients experienced 86 episodes of BSI during the observational period. The source of the BSI was identified only in 38%: catheter-related BSI (27%) peritonitis (7%), urinary tract infection (2%), pneumonia (1%) and infectious endocarditis (1%). A multivariate analysis demonstrated that body weight (P = 0.03), volume of blood loss during LT (P < 0.001) and cytomegalovirus (CMV) antigenemia positivity (P = 0.04) were independently associated with the development of BSI. The risk factors for BSI differed when we analyzed the subjects according to age (≤24 months and >24 months), blood loss and pediatric end-stage liver disease/model for end-stage liver disease versus positive CMV antigenemia.

Conclusions: The volume of blood loss, postoperative CMV antigenemia positivity and body weight were associated with the development of BSI after LT in pediatric living-donor recipients. To identify the age-specific predictors of BSI in children who underwent LT, age-specific analyses are crucial.

Citing Articles

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Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review.

Shieb M, Hasanain R, Arshad Z, Nawaz F, Kashyap R, Stern E Clin Exp Pediatr. 2024; 67(9):427-434.

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A Clinical Model to Predict the Occurrence of Select High-risk Infections in the First Year Following Heart Transplantation.

Perry W, Chow J, Nelson J, Kent D, Snydman D Transplant Direct. 2023; 9(12):e1542.

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Assessment of pathogens and risk factors associated with bloodstream infection in the year after pediatric liver transplantation.

Kim Y, Choi H, Lee H, Oh H, Ahn M, Oh S World J Gastroenterol. 2022; 28(11):1159-1171.

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Epidemiology, Risk Factors and Outcome Due to Multidrug Resistant Organisms in Paediatric Liver Transplant Patients in the Era of Antimicrobial Stewardship and Screening.

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