XXXX after liver transplantation: 1990-2000.

@entity1 @entity4988 @entity409 @entity880 @entity715 @entity375 @entity99
BACKGROUND: Infections following solid-organ transplants are a major cause of morbidity and mortality. Few studies have reported the complications of @entity99 . METHODS: This investigation consisted of a retrospective chart review of all solid-organ transplant recipients from 1990 to 2000. Criteria for diagnosis included @entity409 , positive cultures from liver aspirates or blood cultures, or both, and a compatible clinical presentation. RESULTS: Of 2,175 recipients of all organ transplants (heart, lung, kidney, liver, pancreas), we identified 12 @entity1 who had experienced 14 episodes of @entity99 , all in liver transplant recipients. Median time from transplant to @entity99 was 386 days (range 25-4,198). The most common predisposing factor was @entity715 ( @entity715 ), which occurred in eight @entity1 , and was diagnosed at an average of 249 days (range 33-3,215) after transplantation. Clinical presentation of @entity99 was similar to that described in non-immunosuppressed @entity1 . All but one @entity1 showed @entity4988 (<3.5 g/dL); those with @entity715 also had significantly elevated @entity880 dehydrogenase. Liver aspirates grew gram-positive aerobic bacteria (50% of isolates), gram-negative aerobic bacteria (30%), and anaerobes and @entity375 (10% each). @entity1 received an average of 6 weeks of intravenous antibiotic therapy. Catheter drainage was successful in 70% of cases; and five @entity1 required retransplantation. Altogether, five of the @entity1 died, yielding a mortality rate of 42%. CONCLUSIONS: @entity99 , a rare complication after liver transplantation, was frequently associated with @entity715 . Mortality was higher than in @entity1 who had not undergone transplantation. Prolonged antibiotic therapy, drainage, and even retransplantation may be required to improve the outcome in these @entity1 .
