Hepatic abscess after liver transplantation: 1990???2000
- 1 January 2003
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 75 (1), 79-83
- https://doi.org/10.1097/00007890-200301150-00014
Abstract
Infections following solid-organ transplants are a major cause of morbidity and mortality. Few studies have reported the complications of hepatic abscesses. This investigation consisted of a retrospective chart review of all solid-organ transplant recipients from 1990 to 2000. Criteria for diagnosis included parenchymal hepatic lesions, positive cultures from liver aspirates or blood cultures, or both, and a compatible clinical presentation. Of 2,175 recipients of all organ transplants (heart, lung, kidney, liver, pancreas), we identified 12 patients who had experienced 14 episodes of hepatic abscess, all in liver transplant recipients. Median time from transplant to hepatic abscess was 386 days (range 25-4,198). The most common predisposing factor was hepatic artery thrombosis (HAT), which occurred in eight patients, and was diagnosed at an average of 249 days (range 33-3,215) after transplantation. Clinical presentation of hepatic abscess was similar to that described in non-immunosuppressed patients. All but one patient showed hypoalbuminemia (<3.5 g/dL); those with HAT also had significantly elevated lactate dehydrogenase. Liver aspirates grew gram-positive aerobic bacteria (50% of isolates), gram-negative aerobic bacteria (30%), and anaerobes and yeasts (10% each). Patients received an average of 6 weeks of intravenous antibiotic therapy. Catheter drainage was successful in 70% of cases; and five patients required retransplantation. Altogether, five of the patients died, yielding a mortality rate of 42%. Hepatic abscess, a rare complication after liver transplantation, was frequently associated with hepatic artery thrombosis. Mortality was higher than in patients who had not undergone transplantation. Prolonged antibiotic therapy, drainage, and even retransplantation may be required to improve the outcome in these patients.Keywords
This publication has 17 references indexed in Scilit:
- PYOGENIC LIVER ABSCESSESInfectious Disease Clinics of North America, 2000
- Hepatic allograft abscess with hepatic arterial thrombosisThe American Journal of Surgery, 1998
- Hafnia alvei Infection After Liver TransplantationClinical Infectious Diseases, 1997
- Serum albumin and mortality after renal transplantationAmerican Journal of Kidney Diseases, 1996
- Bloodstream infections after interventional procedures in the biliary tract.Radiology, 1994
- Bacteremia in transplant recipients: A prospective study of demographics, etiologic agents, risk factors, and outcomesAmerican Journal of Infection Control, 1992
- Complications of liver biopsy in liver transplant patients: Increased sepsis associated with choledochojejunostomyHepatology, 1991
- Vascular complications after orthotopic liver transplantationThe American Journal of Surgery, 1991
- HEPATIC ALLOGRAFT RESCUE FOLLOWING ARTERIAL THROMBOSIS: ROLE OF URGENT REVASCULARIZATIONTransplantation, 1991
- Hepatic Bilomas Due to Hepatic Artery Thrombosis in Liver Transplant Recipients: Percutaneous Drainage and Clinical OutcomeRadiology, 1990