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Hepatic abscess after liver transplantation: 1990-2000
Olympia A Tachopoulou1, David P Vogt, J Michael Henderson
1Department of Infectious Disease, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Transplantation
|January 25, 2003
Summary
Hepatic abscesses are rare but serious complications after liver transplantation, often linked to hepatic artery thrombosis. These infections require aggressive treatment, including antibiotics and drainage, and carry a high mortality rate.
Area of Science:
- Transplant Surgery
- Infectious Diseases
- Hepatology
Background:
- Infections post-solid-organ transplant significantly increase morbidity and mortality.
- Hepatic abscesses are a poorly documented complication in transplant recipients.
Purpose of the Study:
- To investigate the incidence, predisposing factors, clinical presentation, and outcomes of hepatic abscesses in solid-organ transplant recipients.
Main Methods:
- Retrospective chart review of solid-organ transplant recipients from 1990 to 2000.
- Inclusion criteria: parenchymal hepatic lesions, positive cultures, and compatible clinical presentation.
Main Results:
- 14 hepatic abscess episodes identified in 12 liver transplant recipients; none in other solid-organ transplants.
- Hepatic artery thrombosis (HAT) was the most common predisposing factor (8 patients).
- Mortality rate was 42%, with treatments including antibiotics, drainage, and retransplantation.
Conclusions:
- Hepatic abscess is a rare but severe complication following liver transplantation, frequently associated with HAT.
- Outcomes can be improved with prolonged antibiotic therapy, drainage, and potentially retransplantation.
- Mortality for hepatic abscess post-transplant is higher than in non-transplanted patients.