Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations

C. V. Paya, P. E. Hermans, J. A. Washington, T. F. Smith, J. P. Anhalt, R. H. Wiesner, R. A F Krom

Research output: Contribution to journalArticle

203 Citations (Scopus)

Abstract

Of 83 patients who underwent 100 orthotopic liver transplantations, 53 had a single transplant procedure and at least 6 monts of follow-up. In this main study group of 53 patients, major infections developed in 28 (53%) (a mean of 1.8 major episodes per infected patient). Of 51 major infections, 27 were bacterial, 19 were viral, 3 were protozoan, and 2 were fungal. Of the 27 bacterial infections, 22 (81%) occurred in the first 2 months after transplantation. Of the 40 bacterial isolates in the 27 bacterial infections, gram-positive aerobic bacteria were isolated in 26 (65%), anaerobic bacteria in 8 (20%), and aerobic gram-negative bacteria in 6 (15%). Only 1 of 16 bacteremic episodes was due to a gram-negative aerobic bacterium. Cytomegalovirus (CMV) infection occurred in 30 of the 53 patients (57%) and was symptomatic and invasive in 18. CMV infection was diagnosed a mean of 26 days after transplantation. Infections due to Pneumocystis carinii occurred later (2 to 3 months after transplantation). Death from infection occurred in 4 of th 53 patients (8%). In the group of 16 patients with two or more liver transplantations, fungal infection occurred in 2 and CMV infection in 13. In all 16 patients who underwent more than one liver transplantation, a major infection developed. The observations made in the main study group were consistent with findings in 13 patients with one liver transplantation but less than 6 months of follow-up. Infection is a major complication after liver transplantation, generally occurring in the first 2 months. Our observations suggest that the use of selective bowel decontamination may be associated with a relatively lower incidence of gram-negative aerobic bacterial infections.

Original languageEnglish (US)
Pages (from-to)555-564
Number of pages10
JournalMayo Clinic Proceedings
Volume64
Issue number5
StatePublished - 1989
Externally publishedYes

Fingerprint

Liver Transplantation
Incidence
Infection
Cytomegalovirus Infections
Gram-Negative Aerobic Bacteria
Transplantation
Bacterial Infections
Gram-Negative Bacterial Infections
Pneumocystis carinii
Aerobic Bacteria
Decontamination
Anaerobic Bacteria
Mycoses
Gram-Positive Bacteria
Transplants

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Paya, C. V., Hermans, P. E., Washington, J. A., Smith, T. F., Anhalt, J. P., Wiesner, R. H., & Krom, R. A. F. (1989). Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations. Mayo Clinic Proceedings, 64(5), 555-564.

Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations. / Paya, C. V.; Hermans, P. E.; Washington, J. A.; Smith, T. F.; Anhalt, J. P.; Wiesner, R. H.; Krom, R. A F.

In: Mayo Clinic Proceedings, Vol. 64, No. 5, 1989, p. 555-564.

Research output: Contribution to journalArticle

Paya, CV, Hermans, PE, Washington, JA, Smith, TF, Anhalt, JP, Wiesner, RH & Krom, RAF 1989, 'Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations', Mayo Clinic Proceedings, vol. 64, no. 5, pp. 555-564.
Paya CV, Hermans PE, Washington JA, Smith TF, Anhalt JP, Wiesner RH et al. Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations. Mayo Clinic Proceedings. 1989;64(5):555-564.
Paya, C. V. ; Hermans, P. E. ; Washington, J. A. ; Smith, T. F. ; Anhalt, J. P. ; Wiesner, R. H. ; Krom, R. A F. / Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations. In: Mayo Clinic Proceedings. 1989 ; Vol. 64, No. 5. pp. 555-564.
@article{e4daad3a5fc44d4e9dc6adf473c6dee1,
title = "Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations",
abstract = "Of 83 patients who underwent 100 orthotopic liver transplantations, 53 had a single transplant procedure and at least 6 monts of follow-up. In this main study group of 53 patients, major infections developed in 28 (53{\%}) (a mean of 1.8 major episodes per infected patient). Of 51 major infections, 27 were bacterial, 19 were viral, 3 were protozoan, and 2 were fungal. Of the 27 bacterial infections, 22 (81{\%}) occurred in the first 2 months after transplantation. Of the 40 bacterial isolates in the 27 bacterial infections, gram-positive aerobic bacteria were isolated in 26 (65{\%}), anaerobic bacteria in 8 (20{\%}), and aerobic gram-negative bacteria in 6 (15{\%}). Only 1 of 16 bacteremic episodes was due to a gram-negative aerobic bacterium. Cytomegalovirus (CMV) infection occurred in 30 of the 53 patients (57{\%}) and was symptomatic and invasive in 18. CMV infection was diagnosed a mean of 26 days after transplantation. Infections due to Pneumocystis carinii occurred later (2 to 3 months after transplantation). Death from infection occurred in 4 of th 53 patients (8{\%}). In the group of 16 patients with two or more liver transplantations, fungal infection occurred in 2 and CMV infection in 13. In all 16 patients who underwent more than one liver transplantation, a major infection developed. The observations made in the main study group were consistent with findings in 13 patients with one liver transplantation but less than 6 months of follow-up. Infection is a major complication after liver transplantation, generally occurring in the first 2 months. Our observations suggest that the use of selective bowel decontamination may be associated with a relatively lower incidence of gram-negative aerobic bacterial infections.",
author = "Paya, {C. V.} and Hermans, {P. E.} and Washington, {J. A.} and Smith, {T. F.} and Anhalt, {J. P.} and Wiesner, {R. H.} and Krom, {R. A F}",
year = "1989",
language = "English (US)",
volume = "64",
pages = "555--564",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "5",

}

TY - JOUR

T1 - Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations

AU - Paya, C. V.

AU - Hermans, P. E.

AU - Washington, J. A.

AU - Smith, T. F.

AU - Anhalt, J. P.

AU - Wiesner, R. H.

AU - Krom, R. A F

PY - 1989

Y1 - 1989

N2 - Of 83 patients who underwent 100 orthotopic liver transplantations, 53 had a single transplant procedure and at least 6 monts of follow-up. In this main study group of 53 patients, major infections developed in 28 (53%) (a mean of 1.8 major episodes per infected patient). Of 51 major infections, 27 were bacterial, 19 were viral, 3 were protozoan, and 2 were fungal. Of the 27 bacterial infections, 22 (81%) occurred in the first 2 months after transplantation. Of the 40 bacterial isolates in the 27 bacterial infections, gram-positive aerobic bacteria were isolated in 26 (65%), anaerobic bacteria in 8 (20%), and aerobic gram-negative bacteria in 6 (15%). Only 1 of 16 bacteremic episodes was due to a gram-negative aerobic bacterium. Cytomegalovirus (CMV) infection occurred in 30 of the 53 patients (57%) and was symptomatic and invasive in 18. CMV infection was diagnosed a mean of 26 days after transplantation. Infections due to Pneumocystis carinii occurred later (2 to 3 months after transplantation). Death from infection occurred in 4 of th 53 patients (8%). In the group of 16 patients with two or more liver transplantations, fungal infection occurred in 2 and CMV infection in 13. In all 16 patients who underwent more than one liver transplantation, a major infection developed. The observations made in the main study group were consistent with findings in 13 patients with one liver transplantation but less than 6 months of follow-up. Infection is a major complication after liver transplantation, generally occurring in the first 2 months. Our observations suggest that the use of selective bowel decontamination may be associated with a relatively lower incidence of gram-negative aerobic bacterial infections.

AB - Of 83 patients who underwent 100 orthotopic liver transplantations, 53 had a single transplant procedure and at least 6 monts of follow-up. In this main study group of 53 patients, major infections developed in 28 (53%) (a mean of 1.8 major episodes per infected patient). Of 51 major infections, 27 were bacterial, 19 were viral, 3 were protozoan, and 2 were fungal. Of the 27 bacterial infections, 22 (81%) occurred in the first 2 months after transplantation. Of the 40 bacterial isolates in the 27 bacterial infections, gram-positive aerobic bacteria were isolated in 26 (65%), anaerobic bacteria in 8 (20%), and aerobic gram-negative bacteria in 6 (15%). Only 1 of 16 bacteremic episodes was due to a gram-negative aerobic bacterium. Cytomegalovirus (CMV) infection occurred in 30 of the 53 patients (57%) and was symptomatic and invasive in 18. CMV infection was diagnosed a mean of 26 days after transplantation. Infections due to Pneumocystis carinii occurred later (2 to 3 months after transplantation). Death from infection occurred in 4 of th 53 patients (8%). In the group of 16 patients with two or more liver transplantations, fungal infection occurred in 2 and CMV infection in 13. In all 16 patients who underwent more than one liver transplantation, a major infection developed. The observations made in the main study group were consistent with findings in 13 patients with one liver transplantation but less than 6 months of follow-up. Infection is a major complication after liver transplantation, generally occurring in the first 2 months. Our observations suggest that the use of selective bowel decontamination may be associated with a relatively lower incidence of gram-negative aerobic bacterial infections.

UR - http://www.scopus.com/inward/record.url?scp=0024391513&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024391513&partnerID=8YFLogxK

M3 - Article

C2 - 2542701

AN - SCOPUS:0024391513

VL - 64

SP - 555

EP - 564

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 5

ER -