Impact of pre-transplant infection management on the outcome of living-donor liver transplantation in Egypt

Figures & data

Table 1 Demographic, clinical, and laboratory features of the studied group

	Mean	Normal range	SD
Age	47.1		±9.7
MELD score	16.2		±3.9
INR	1.5	(1–1.2)	±0.37
TLC (cells/mm^3)	4.8×10^3	(4–11)	±2.12
CRP (mg/L)	10.25	(0–6)	±11.38
Albumin (g/dL)	2.66	(3.5–5.5)	±0.66
Creatinine (mg/dL)	0.93	(0.6–1.2)	±0.35
Bilirubin (mg/dL)	3.7	(0.3–1)	±2.8
ESR (mm/h)	38.8	(0–15)	±25.8
	n		%
Sex
Male	42		84
Female	8		16
Child–Pugh score
A	6		12
B	14		28
C	30		60
Indication for LT
HCV-CLD	40		80
HBV-CLD	2		4
AIH-CLD	4		8
Cryptogenic CLD	4		8
Patients who had HCC	13		26

Abbreviations: MELD, Model for End-Stage Liver Disease; INR, international normalized ratio; TLC, total lymphocyte count; ESR, erythrocyte-sedimentation rate; LT, liver transplantation; HCV, hepatitis C virus; CLD, chronic liver disease; AIH, autoimmune hepatitis; HCC, hepatocellular carcinoma.

Table 2 Descriptive analysis of episodes of pre-transplant infection (n=29) found in 20 living-donor liver-transplant recipients

	n	%
Infection
Present	20	40
Absent	30	60
Type of infections
Chest	3	15
UTI	3	15
Nasal	3	15
Chest and nasal	3	15
Chest and UTI	2	10
SBP	2	10
Chest, nasal, and SBP	1	5
Chest and SBP	1	5
UTI and nasal	1	5
Gastroenteritis	1	5
Frequency of infection by site
Chest	10	50
Nasal	8	40
UTI	6	30
SBP	4	20
Gastroenteritis	1	5
Time of last infection prior to operation
Less than 1 month	2	10
1–2 months	14	70
2–3 months	4	20

Abbreviations: UTI, urinary tract infection; SBP, spontaneous bacterial peritonitis.

Table 3 Post-operative course of both groups

	Group 1 (n=20)		Group 2 (n=30)		P-value
	n	%	n	%
Hospital stay (days)	19.6±6.1		23±10.1		0.185
ICU stay (days)	8.2±5.6		7.1±3.3		0.403
Complications
Yes	11	55.0	19	63.3	0.349
No	9	45.0	11	36.7
Surgical complications
Yes	3	15.0	9	33.3	0.720
No	17	85.0	23	66.7
Medical complications
Yes	8	35	10	30	0.902
No	13	65	20	60
Infection	6	30	2	6.6	0.027
Mortality	8	40	7	23.3	0.208
Mortality causes
Medical	6	75	2	28.6	0.132
Surgical	2	25	5	71.4

Notes: Group 1: patients with treated infections. Group 2: patients without infection.

Table 4 Episodes of post-transplant infection (n=11) found in eight living-donor liver-transplant recipients

Infection category	Organisms	Episodes
Chest infection	Escherichia coli and streptococci Acinetobacter and Klebsiella pneumoniae	16.6% (2/12)
Bloodstream infections	E. coli Enterococci	16.6% (2/12)
Intra-abdominal infections	Enterococci Staphylococcus aureus and Gram-negative bacilli, ESBL strain E. coli — enterococcus	25% (3/12)
Nasal infection	Streptococcus saprophyticus	8.3% (1/12)
Necrotizing fasciitis	Streptococcus and Staphylococcus aureus	8.3% (1/12)
Maxillary sinusitis	Streptococcus aureus pneumonia	8.3% (1/12)
Wound infection	E. coli	8.3% (1/12)