Infections after living donor liver transplantation in children

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Transplantation Immunology

Background:

• Living donor liver transplantation (LDLT) is a critical procedure for children with end-stage liver disease.
• Infectious complications represent a significant challenge following pediatric LDLT, impacting patient morbidity and mortality.
• Understanding the spectrum and impact of infections is vital for optimizing post-transplant care.

Purpose of the Study:

• To evaluate the incidence and types of infectious complications after pediatric LDLT.
• To identify the primary sources and timing of bacterial, viral, and fungal infections.
• To determine the association between specific infections and patient mortality.

Main Methods:

• Retrospective analysis of 95 pediatric patients who underwent LDLT between 1994 and 2004.
• Investigation of proven episodes of bacterial, viral, and fungal infections.
• Analysis of infection sites, causative agents, and correlation with mortality.

Main Results:

• A total of 150 infections occurred in 67% of patients, with bacterial (74 episodes) and viral (74 episodes) infections being most common.
• Bacterial infections primarily affected the bloodstream and abdomen, occurring mostly within the first month post-transplant.
• Viral infections, notably Epstein-Barr virus and cytomegalovirus, were associated with 7 out of 14 deaths, while bacterial and fungal infections did not cause mortality.

Conclusions:

• Infection is a major contributor to morbidity and mortality following pediatric LDLT.
• Viral infections pose a significant threat and require vigilant monitoring and management.
• Optimizing the care of pediatric LDLT recipients necessitates a focus on preventing and treating infectious complications, particularly viral ones.