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Methicillin-resistant Staphylococcus aureus infection after living-donor liver transplantation in adults

M Hashimoto1, Y Sugawara, S Tamura

  • 1Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|July 4, 2007
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) infection is a risk after Living-donor Liver Transplantation (LDLT). Preoperative MRSA colonization, longer operations, and postoperative apheresis predict infection risk in LDLT patients.

Area of Science:

  • Hepatology
  • Transplant Surgery
  • Infectious Diseases

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) infections are common after deceased-donor liver transplants.
  • Risk factors for MRSA in Living-donor Liver Transplantation (LDLT) are not well understood.

Purpose of the Study:

  • To determine the incidence and identify independent risk factors for postoperative MRSA infection following LDLT.

Main Methods:

  • Retrospective review of 242 adult LDLT patients at University of Tokyo Hospital.
  • Analysis of microbiologic and medical records from admission to 3 months post-transplant.
  • Univariate and multivariate analyses to identify risk factors.

Main Results:

  • MRSA infection occurred in 25/242 patients by postoperative day 23.
  • Independent predictors of MRSA infection included preoperative MRSA colonization, preoperative antibiotic use, operation time (>=16 hours), and postoperative apheresis.

Conclusions:

  • Periodic surveillance cultures are recommended to identify high-risk patients for MRSA infection.
  • Postoperative apheresis may indicate liver dysfunction and predispose patients to MRSA infection.
  • Targeted antimicrobial strategies are crucial for perioperative infection prevention.

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