Analysis of early infection and bacterial drug resistance in liver transplant patients from organ donation after death

Abstract

Objective To investigate the effects of liver grafts from different sources on the early infection and bacterial drug resistance in the recipients after liver transplantation. Methods Clinical data of 296 recipients undergoing orthotopic liver transplantation in Dongfang Hospital Affiliated to Xiamen University from January 2009 to December 2017 were retrospectively analyzed. Among them, 216 patients were male and 80 female, aged (49±13) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. According to different sources of liver grafts, the recipients were divided into the standard criteria donor (SCD, n=197) and donation after citizen's death groups (DCD, n=99). Preoperative and intraoperative covariates between two groups were balanced with propensity score matching (PSM). Early postoperative infection and bacterial drug resistance of two groups were analyzed. The rate comparison was performed by using Chi-square test. Results After PSM, 89 eligible patients were recruited in each group. The overall infection rate in the DCD group within postoperative2 months was 60%(53/89), significantly higher than 43%(38/89) in the SCD group (χ2=5.059, P 0.05). Postoperatively, 81 and 66 pathogens were cultured in DCD and SCD groups, respectively. The percentage of bacteria among pathogens in two groups was respectively 81%(66/81) and 86%(57/66). Gram-positive bacteria were the main bacteria. The multidrug resistance rates in DCD and SCD groups were 39%(26/66) and 47%(27/57) , where no significant difference was observed (χ2=1.306, P>0.05). Conclusions Compared with liver grafts procured from SCD, the abdominal infection rate increased in patients of DCD liver transplantation, but in the infection rate of multidrug-resistant bacteria and the incidence rate of pulmonary infection do not increase. Key words: Liver transplantation; Donation after citizen's death; Infection; Multi-drug resistance