Abdominal Solid Organ Research Articles

Microbubbles in the belly: optimizing the protocol for contrast-enhanced ultrasound of the pediatric abdomen.

Intravenous contrast-enhanced ultrasound (CEUS) can serve as a diagnostic or problem-solving tool in pediatric imaging. CEUS of abdominal solid organs has been reported for a number of indications. The approach to the examination broadly falls into two categories: evaluation of a focal lesion or surveillance of an organ or organs for lesions or perfusion abnormalities. A consistent, technical imaging protocol for both of these clinical scenarios facilitates integration of routine use of CEUS in an imaging department. Here we review the CEUS imaging protocols for abdominal organs in children, including technical and solid-organ-specific considerations.

Associations between social determinants of health and abdominal solid organ transplant wait-lists in the United States.

Societal factors that influence wait-listing for transplantation are complex and poorly understood. Social determinants of health (SDOH) affect rates of and outcomes after transplantation. This cross-sectional study investigated the impact of SDOH on additions to state-level, 2017-2018 kidney and liver wait-lists. Principal components analysis, starting with 127 variables among 3142 counties, was used to derive novel, comprehensive state-level composites, designated (1) health/economics and (2) community capital/urbanicity. Stepwise multivariate linear regression with backwards elimination (n=51; 50 states and DC) tested the effects of these composites, Medicaid expansion, and center density on adult disease burden-adjusted wait-list additions. SDOH related to increased community capital/urbanicity were independently associated with wait-listing (starting models: B=.40, P =.010 Kidney; B =.36, P =.038 Liver) (final models: B =.31, P =.027 Kidney, B =.34, P =.015 Liver). In contrast and surprisingly, no other covariates were associated with wait-listing (P≥.122). These results suggest that deficits in community resources are important contributors to disparities in wait-list access. Our composite SDOH metrics may help identify at-risk communities, which can be the focus of local and national policy initiatives to improve access to organ transplantation.

Current Trends of Conservative Management of Blunt Abdominal Solid Organ Injury

Introduction: Bangladesh is one of the most densely inhabited countries in the world. Road traffic accidents are one of the leading causes of morbidity, and the incidence of blunt abdominal injuries is on the rise. Over the last several years, the treatment of blunt abdominal injury (BAI) has changed dramatically. Conservative or non-operative treatment (NOM) of liver, spleen, and kidney injuries has proven to be quite effective. Methods of study: A prospective observational study was done in Dhaka medical college with 50 consecutive patients included from January 2010 to June 2010. Results: Within the 50 consecutive patients 88% were male, and 64% were motor vehicular crashes. 26 patients (52%) had a liver injury; 5 (10%) had a renal injury; 7 (14%) had a splenic injury and 3 (6%) had a pancreatic injury; 9(18%), 2 patients (4%) had both liver and spleen injury, 3 patients (6%) had both spleen and kidney injury. 39 (78%) patients were managed successfully by a conservative approach. Compared with these patients who underwent non-operative management (NOM) initially, patients in the operative group had a higher injury severity score. (p < 0.001). Twenty-seven patients (high risk) were successfully treated without surgery. No serious complication was found on routine image follow-up. Conclusion: Conservative or non-operative management of blunt abdominal solid organ injury in hemodynamically stable patients is highly successful in many fields when compared with the operative group, including the outcomes of morbidity, mortality, and length of hospital stay.

Nonoperative management with angioembolization for blunt abdominal solid organ trauma in hemodynamically unstable patients: a systematic review and meta-analysis.

The objective of the present study is to provide a comprehensive review of the literature on associated outcomes of angioembolization in blunt abdominal solid organ traumas. The databases of Medline, Embase, and Cochrane Library were explored until 24 September 2021. All studies with data on the efficacy or safety of angioembolization in patients suffering from hemodynamically unstable blunt abdominal solid organ trauma were included. The primary outcomes were clinical success rate and mortality. Pooled event rates were calculated using a double arcsine transformation to stabilize the variance of the original proportion. In total, 13 reports of 12 studies were included in the systematic review. According to the current meta-analysis, the angioembolization for blunt abdominal solid organ trauma in hemodynamically unstable patients had a high clinical success rate [0.97 (95% CI 0.93-0.99)] and low mortality [0.03 (95% CI 0.01-0.07)]. Furthermore, no statistically significant difference was found between the various injured solid organs for either of these parameters. In addition, the technique-associated adverse events were seldom and tolerable. For blunt abdominal solid organ trauma in hemodynamically unstable patients, this review shows that angioembolization exhibited a high clinical success rate, low mortality, and tolerable technique-related adverse events. Furthermore, the top possible indication for angioembolization in hemodynamically unstable patients is an individual who responds to rapid fluid resuscitation. However, high-quality and large-scale trials are needed to confirm these results and determine the selection criteria for appropriate patients in this setting.

Short-term kidney transplant outcomes from severe acute respiratory syndrome coronavirus 2 lower respiratory tract positive donors.

ObjectiveIn this study, we aim to assess short‐term allograft outcomes following deceased donor kidney transplantation from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) lower respiratory tract (LRT) nucleic acid testing (NAT) positive donors.MethodsFrom September to December 2021, SARS‐CoV‐2 NAT positive organ donors, whose solid abdominal organs were transplanted at our academic medical center were identified. Donors were stratified into having tested positive for SARS‐CoV‐2 in an upper respiratory tract (URT) or LRT sample. For this study, the SARS‐CoV‐2 LRT NAT positive deceased kidney donors and their respective recipients were examined. Donor and recipient demographic data, coronavirus disease 2019 (COVID‐19)‐related history, patient outcomes, as well as postoperative graft function were evaluated.ResultsThirteen SARS‐CoV‐2 positive deceased donors were identified. Of these, eight were LRT NAT positive and yielded nine kidneys. These allografts were successfully transplanted into vaccinated and unvaccinated recipients. All recipients received standard induction immunosuppression and did not receive any prophylactic therapy for SARS‐CoV‐2. Two recipients had delayed graft function. At 1‐month post‐transplant, there was no clinical evidence of donor‐derived COVID‐19 or graft loss, and all recipients were free from dialysis.ConclusionWe describe the first case series of SARS‐CoV‐2 LRT NAT positive deceased kidney donors for vaccinated and unvaccinated recipients with excellent short‐term allograft outcomes and no clinical evidence of donor‐derived COVID‐19 post‐transplantation. Given the increasing prevalence of SARS‐CoV‐2 in the population, utilization of SARS‐CoV‐2 LRT NAT positive deceased donors could be considered an acceptable source of organs for renal transplantation, especially as multi‐center experiences and longer‐term follow‐up emerge.

ISOLATED PANCREATIC INJURIES: A CASE SERIES

Context: Pancreatic injuries constitutes a set of rare abdominal solid organ injuries. Isolated pancreatic injuries are even more rare injuries and are often missed in initial clinical and radiological evaluation . such injuries present late and denitive guidelines to manage such injuries are lacking, considering rarity of such injuries. Unpredictable course involves traumatic pancreatitis, pancreatic necrosis, peripancreatic collections, infective complications and extra abdominal complication The aim of this study is to present clinical details and management outcomes of such casesAims: at our institute This study is a retrospective analytical study In this retrospective study medicalSettings and Design: Methods and Material: records of all the admissions were collected from trauma registry from may 2016 to april 2022 at Thanjavur medical college. All these records were screened for patients with isolated pancreatic injuries All continuous variables were analyzed with descriptive statisticsStatistical analysis used: and their mean, median, mode, range and frequencies were calculated. All categorical data are analyzed with frequencies. Comparison of data is done using: all nominal data is analyzed with parametric tests (Chi-square test, unpaired t test) and non-nominal data is analyzed with non- parametric tests (Fischer's exact test and Mann-whitney U test). In our study a total of 22 cases were included. Mean age being 33.91yearsResults: among which 81.8% were males. 72.7% of the patients suffered road trafc accidents. 77.3% of the patients had BMI less than 25. Main pancreatic duct (MPD) involvement was noticed in 22.7% patients. median levels of serum amylase levels were 390U/L. 22.7% patients underwent operative management were as rest were managed non-operatively. Two patients died due to severe pancreatitis. Isolated pancreatic injuries inConclusions: patients where surgery is otherwise not indicated due to other causes needs management tailored to the clinical needs of the patient. Diagnostic ambiguity is best resolved by combining computed tomography (CT) and Magnetic resonance cholangiopancreatography (MRCP). Patients with distal MPD injury are usually operated when presented early and pancreatic stenting is considered when proximal ductal injury is noticed. In selected cases conservative approach is not a contraindication, even in patients with MPD injury, considering high stula and peripancreatic collection rates in distal pancreatectomy.

Indications for the surgical management of pancreatic trauma: An update.

Pancreatic trauma is rare compared to other abdominal solid organ injuries, accounting for 0.2%-0.3% of all trauma patients. Moreover, this type of injury may frequently be overlooked or not readily appreciated on initial clinical examinations and investigations. The organ injury scale determines the severity of the trauma. Nonetheless, there are conflicting recommendations for the best strategy in severe cases. Overall, conservative management of induced severe traumatic pancreatitis is adequate. Modern imaging modalities such as ultrasound scanning and computed tomography scanning can detect injuries in fewer than 60% of patients. However, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) have diagnostic accuracies approaching 90%-100%. Thus, management options include ERCP and stent placement or distal pancreatectomy in cases of complete gland transection and wide drainage only for damage control surgery, which can prevent mortality but increases the risk of morbidity. In the majority of cases, surgical intervention is not required and should be reserved for only severe grade III to grade V injuries.

Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?

BackgroundThis study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM. MethodsA 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified into two groups based on their history of pre-injury anticoagulant use. Propensity score matching was performed. ResultsA matched cohort of 2709 patients (AC, 903; No-AC,1806) was analyzed. Compared to the No-AC group, the AC group had higher rates of failure of NOM(2.6% vs. 4.5%, p = 0.03), cardiac arrest (1.2%vs. 3.1%, p = 0.02), acute kidney injury (2.4% vs. 4.2%, p < 0.01), myocardial infarction (0.6% vs. 1.4%,p = 0.03), and mortality (5.1%vs. 7.6%,p = 0.01), and longer hospital LOS (17[10–24]vs.17[12–26]days,p = 0.04) and ICU LOS (11[6–17]vs.11[7–18]days,p = 0.01). ConclusionAmong nonoperatively managed blunt abdominal SOI patients, preinjury use of anticoagulants negatively impacts outcomes. Extra surveillance is required while managing patients with blunt abdominal SOI on pre-injury anticoagulants. Level of evidenceLevel III. Study typeTherapeutic/care management.

Intraosseus administration of an ultrasound contrast agent in a case of pediatric blunt abdominal trauma

Adding an ultrasound contrast agent to the Focused Assessment with Sonography in Trauma (FAST) exam can substantially improve the diagnostic accuracy of identifying solid organ injuries and rapidly identify significant organ lacerations and active intraperitoneal hemorrhage. The standard recommendations are to use a 20g peripheral IV for administration to prevent microbubble breakage associated with high infusion pressures. In time-critical trauma resuscitations however, rapid vascular access often necessitates the use of intraosseous catheters (IO). We describe the first use of IO access to successfully administer an ultrasound contrast agent in a critically injured 16 month-old toddler. The cFAST exam identified a liver laceration and provided superior diagnostic information compared the non-contrast abdominal CT obtained at an outside facility. • Adding an ultrasound contrast agent to the FAST exam can help to rapidly diagnose significant solid abdominal organ injuries. • Ultrasound contrast arrival times and organ opacification appear to be similar to the intravenous route. • A contrast-enhanced FAST exam (cFAST) can provide superior diagnostic information compared to an unenhanced abdominal CT.

Interventional endoscopy for abdominal transplant patients

Interventional endoscopy can play a significant role in the care and management of children pre-and post- abdominal solid organ transplantation. Such procedures primarily include endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), and balloon-assisted enteroscopy (BAE), though additional interventions are available using standard endoscopes (gastroscopes, colonoscopes) for therapeutics purposes such as endoscopic hemostasis.The availability of pediatric practitioners with the advanced training to effectively and safely perform these procedures are most often limited to large tertiary care pediatric centers. These centers possess the necessary resources and ancillary staff to provide the comprehensive multi-disciplinary care needed for these complex patients.In this review, we discuss the importance of interventional endoscopy in caring for transplant patients, during their clinical course preceding the potential need for solid organ transplantation and inclusion of a discussion related to endoscopic post-surgical complication management. Given the highly important role of interventional endoscopy in patients with recurrent and chronic pancreatitis, we also include a discussion related to this complex disease process leading up to those patients that may need pancreas surgery including total pancreatectomy with islet autotransplantation (TPIAT).

Organ allocation in pediatric abdominal transplant

Pediatric patients constitute an important group within the general transplant population, given the opportunity to significantly extend their lives with successful transplantation. Children have historically received special consideration under the various abdominal solid organ allocation algorithms, but matching patients with size and weight restrictions with appropriate donors remains an ongoing issue. Here, we describe the historical trends in pediatric organ allocation policies for liver, kidney, intestine, and pancreas transplantation. We also review recent changes to these allocation policies, with particular attention to recent amendments to geographical prioritization, with the dissolution of donor service areas and United Network for Organ Sharing (UNOS) regions and the subsequent creation of acuity circles.

Anesthetic considerations for pediatric abdominal solid organ transplantation

While many pediatric patients undergo abdominal solid organ transplants every year worldwide, each is unique due to varying age, size, and comorbidities; thus, they require a careful anesthesia plan to undergo surgery safely. This article reviews the anesthetic considerations and management of patients undergoing liver and kidney transplantation. Preoperative, intraoperative, and post-operative management are discussed, including induction, access, monitoring, and maintenance. Blood transfusion is also addressed.

Difference in Presentation and Concomitant Intra-Abdominal Injury with Chance Fracture in Pediatric and Adult Populations.

Chance fracture (CFx) with concomitant intra-abdominal injury has variable occurrence rates ranging from 33 to 89%. No single study has compared the incidence of simultaneous abdominal injury between pediatric and adult populations. This study compares the rate of simultaneous intra-abdominal injury and chance fracture in these populations. A retrospective review of pediatric and adult patients with chance fracture in comparable pediatric and adult trauma centers was performed. Patient demographics, mechanism of injury (MOI), and injury patterns were collected from 2002 to 2019 for pediatric patients and 2015 to 2018 for adults. Student t-test analyses were performed to determine statistical significance between the cohorts. The pediatric group had a similar incidence of abdominal solid organ injuries compared to adults (16 [20.5%] vs. 40 [19.7%], p<0.879), but the pediatric group had a greater number of total intra-abdominal (49 [62.8%] vs. 47 [23.1%], p < 0.001) and hollow organ injuries (40 [51.3%] vs. 17 [8.4%], p < 0.001). Motor vehicle collision was the most common mechanism of injury for both groups (72 pediatric [92.3%] vs. 85 adult [41.7%]) but adults suffered from more falls (3 pediatric vs. 81 adult, p < 0.001). Pediatric patients with CFx caused by MVCs had more intra-abdominal injuries (48 [66.7%] vs. 25[29.8%], p < 0.001) and hollow organ injuries compared to adults (39 [54.2%] vs. 8[9.5%], p < 0.001). In the setting of Chance fracture after trauma, pediatric patients are more likely to have a concomitant intra-abdominal organ injury (63% vs. 23%), especially hollow viscus injury (51.3% vs. 8.4%) compared with adults regardless of mechanism.

Surgical Skills in General Surgery Residency Program: Current Trends and Future Directions

Today, general surgery residents (GSR) face unorthodox challenges due to variation in caseloads and the implementation of duty hour restrictions. It has been stated that the most concerning change in the education of GSRs was the downward trend in weekly operative cases. The integration of surgical skills labs utilizing human body donors could prove to be beneficial for education. The use of human body donors for anatomy education is not a novel idea, however research needs to be done to better understand pros and cons of different preservation methods for surgical skill training. Traditionally formaldehyde is used as the main preservative however soft‐preservation techniques (such as alcohol and Thiel) and fresh‐frozen methods have been gaining popularity as an educational tool for professional students and surgical residents due to the many lifelike qualities the tissue retains during preservation. Studies using soft preserved donors have investigated skill confidence of GSR which all showed an increase in confidence for surgical skills for all PGY residents. Some of these skills include: surgical airway, tracheoesophageal injuries, thoracotomy‐cardiac injury, solid abdominal organ injury, and more. Integration of human body donors into GSR programs has proven to be advantageous for development of surgical skills and confidence in the capabilities of surgical residents. In an effort to improve anatomy education and surgical skill development for general surgery residents additional research should be done. Future studies need to compare the various educational anatomical models and preservation methods could prove to be advantageous.

Timing of pharmacologic venous thromboembolism prophylaxis initiation for trauma patients with nonoperatively managed blunt abdominal solid organ injury: a systematic review and meta-analysis

BackgroundBlunt abdominal solid organ injury is common and is often managed nonoperatively. Clinicians must balance risk of both hemorrhage and thrombosis. The optimal timing of pharmacologic venous thromboembolism prophylaxis (VTEp) initiation in this population is unclear. The objective was to evaluate early (< 48 h) compared to late initiation of VTEp in adult trauma patients with blunt abdominal solid organ injury managed nonoperatively.MethodsEmbase, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched from inception to March 2021. Studies comparing timeframes of VTEp initiation were considered. The primary outcome was failure of nonoperative management (NOM) after VTEp initiation. Secondary outcomes included risk of transfusion, other bleeding complications, risk of deep vein thrombosis (DVT) and pulmonary embolism, and mortality.ResultsTen cohort studies met inclusion criteria, with a total of 4642 patients. Meta-analysis revealed a statistically significant increase in the risk of failure of NOM among patients receiving early VTEp (OR 1.76, 95% CI 1.01–3.05, p = 0.05). There was no significant difference in risk of transfusion. Odds of DVT were significantly lower in the early group (OR 0.36, 95% CI 0.22–0.59, p < 0.0001). There was no difference in mortality (OR 1.50, 95% CI 0.82–2.75, p = 0.19). All studies were at serious risk of bias due to confounding.ConclusionsInitiation of VTEp earlier than 48 h following hospitalization is associated with an increased risk of failure of NOM but a decreased risk of DVT. Absolute failure rates of NOM are low. Initiation of VTEp at 48 h may balance the risks of bleeding and VTE.

STRUCTURE OF TRAUMATIC INJURIES AND EXPERIENCE IN THE TREATMENT OF THE WOUNDED PATIENTS, AS A RESULT OF HOSTILITIES IN THE FIRST DAYS OF RUSSIA’S ATTACK ON UKRAINE

Introduction. All the gunshot wounds are of high-energy. Gunshot and blast injuries, in most cases, are multiple, varying in depth and area of the wound surface. From the first day of the full-scale invasion of Russian troops (February 24, 2022), many victims of hostilities on the right bank of the Dnipro river in Kyiv were hospitalized in our hospital, which is one of the clinical bases of the Department of Anesthesiology and Intensive Care of the Bogomolets National Medical University. Dozens of wounded patients needed simultaneous interventions, and the presence of only 5 operating tables in the facility did not prevent the provision of appropriate qualified medical care to 6-8 critical patients at the same time.&#x0D; The goal of the work. To determine the structure and severity of traumatic injuries received as a result of hostilities.&#x0D; Materials and methods. In the study a prospective analysis of 89 patients who were injured in hostilities for the period from February 24 and March 3 2022, and were hospitalized in one of the clinical bases of the Department of Anesthesiology and Intensive Care of the Bogomolets National Medical University was conducted.&#x0D; Results and discussion. Lesions of one anatomical area occurred in 54 people (60.7%), lesions of two or more anatomical areas – in 35 people (39.3%). Most injured patients – 61 (68.5%), required from 2 to 6 surgeries, which was due to damage to various anatomical areas or the need for phased surgical interventions, including the use of damage-control surgery. Of the 66 patients with limb and pelvic bone injuries, mine explosions or gunshot fractures of the long bones of arms and legs, 41 were injured, and all were treated on an orthopedic basis. Damage-control surgery for injuries of abdominal organs was used in 5 wounded patients. In two patients, damage-control surgery was used for injuries of the pleural cavity. 9 patients (10.1%) of the 89 hospitalized with traumatic injuries received as a result of hostilities died.&#x0D; Conclusion. Extremities and pelvic bones injuries dominate in the structure of combat injuries – 66 (43.7%) patients; chest injuries were in 31 (20.5%) patients; head and neck injuries in 27 (17.9%) patients; abdominal solid organs and pelvic organs injuries in 19 (12.6%) patients; facial injuries in 8 (5.3%) patients. Damage of two or more anatomical areas occurred in 39.3% of patients affected by the hostilities. Most of the wounded patients – 68.5%, required from 2 to 6 surgeries.

A tribute to Daniel H. Teitelbaum, M.D.

While many pediatric patients undergo abdominal solid organ transplants every year worldwide, each is unique due to varying age, size, and comorbidities; thus, they require a careful anesthesia plan to undergo surgery safely. This article reviews the anesthetic considerations and management of patients undergoing liver and kidney transplantation. Preoperative, intraoperative, and post-operative management are discussed, including induction, access, monitoring, and maintenance. Blood transfusion is also addressed.

Surgical approach to Hirschsprung disease

Interventional endoscopy can play a significant role in the care and management of children pre-and post- abdominal solid organ transplantation. Such procedures primarily include endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), and balloon-assisted enteroscopy (BAE), though additional interventions are available using standard endoscopes (gastroscopes, colonoscopes) for therapeutics purposes such as endoscopic hemostasis.The availability of pediatric practitioners with the advanced training to effectively and safely perform these procedures are most often limited to large tertiary care pediatric centers. These centers possess the necessary resources and ancillary staff to provide the comprehensive multi-disciplinary care needed for these complex patients.In this review, we discuss the importance of interventional endoscopy in caring for transplant patients, during their clinical course preceding the potential need for solid organ transplantation and inclusion of a discussion related to endoscopic post-surgical complication management. Given the highly important role of interventional endoscopy in patients with recurrent and chronic pancreatitis, we also include a discussion related to this complex disease process leading up to those patients that may need pancreas surgery including total pancreatectomy with islet autotransplantation (TPIAT).

Antibiotic Stewardship and Inpatient Clostridioides difficile Testing in Solid Organ Transplant Recipients: The Need for Multilevel Checks and Balances

Diarrhea among recipients of solid organ transplants is a commonly encountered problem and is often multifactorial in etiology. Owing to the combination of perioperative antibiotic administration and the immunosuppressed status of transplant recipients, a high degree of suspicion for Clostridioides difficile (C. difficile) colitis is prudent. The purpose of this study is to demonstrate the association of an institutional integrated stewardship program with C. difficile testing practices after abdominal solid organ transplantation. Starting in July 2017, a diagnostic stewardship was enacted in our institution requiring the ordering provider to answer a series of questions within the electronic medical record before ordering a C. difficile toxin test. The charts were reviewed for all solid organ transplant recipients on whom a test was ordered between January 2016 and September 2019. Orders for C. difficile toxin per quarter significantly decreased in the postintervention era (18 vs 8.5, P=.038). Median cost of inpatient treatment and days of therapy per thousand patient days was significantly lower in the postintervention era (median cost, $2,944.55 vs $416.92; P=.01) (days of therapy per thousand patient days, 521.9 vs 300.5; P < .01). Quarterly rates of negative tests were similar between the pre- and postintervention eras (65% vs 73%, P=.38). Although no orders were blocked based on the responses, this multilevel intervention was associated with a 47% decrease in C. difficile testing without effecting the rate of negative testing. These results suggest that we have achieved significant cost savings, in testing and isolation, without sacrificing critical aspects of clinical care.

Colistin (Polymyxin E) Use in Abdominal Solid Organ Transplant Recipients

Background: Patients undergoing solid organ transplantation are at a higher risk of multi-drug resistant (MDR) bacterial infections especially during the immediate post operative period. Objective: To audit the usage, dosage appropriateness and safety of colistin use in abdominal solid organ transplant recipients to treat immediate post-transplant bacterial infections. Methods: After completion of 1000 abdominal solid organ transplants at our institute, data of the transplant recipients who received colistin between October 2010 and December 2019 was extracted from the hospital health information system. Data of all microbiological culture isolates, the minimum inhibitory concentration (MIC) of colistin, appropriateness of colistin dosing and nephrotoxicity associated with colistin use was assessed. Results: Of the 1170 (732 liver and 438 renal) solid organ transplant recipients, 82 (66 liver and 16 renal) received colistin to treat posttransplant MDR bacterial infections. Nearly 60% received colistin as definitive therapy and 87.81% received colistin as combination. Mean duration of colistin therapy was found to be higher in renal than liver transplant recipients. Out of the total 89 bacterial isolates, there were 2 colistin resistant Klebsiella strains. Colistin in combination with meropenem (36.4%) was the most commonly used dual therapy. Out of the total 89 bacterial isolates, there were 2 colistin resistant Klebsiella strains. Overall in-hospital mortality of patients who received colistin was 43.9%. Renal impairment occurred in 28.8% of liver transplant recipients. Conclusion: Infection necessitating colistin use increases mortality by three folds in liver transplant recipients and by five percentage points in renal transplant recipients.