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Infection after liver transplantation.

R S Markin1, R J Stratta, G L Woods

  • 1Department of Pathology, University of Nebraska Medical Center, Omaha.

The American Journal of Surgical Pathology
|January 1, 1990
PubMed
Summary

Liver transplant recipients face significant infection risks. Early diagnosis using advanced methods like PCR can reduce post-transplant morbidity and mortality from bacterial, viral, fungal, and protozoal infections.

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Area of Science:

  • Transplant Medicine
  • Infectious Diseases

Background:

  • Liver transplant recipients are susceptible to significant morbidity and mortality from infections.
  • Factors influencing infection include nutritional status, latent viruses, and immunosuppression intensity.
  • Infectious agents can be introduced via the allograft, blood products, or medical devices, or arise from endogenous sources.

Purpose of the Study:

  • To review the types and causes of infections in liver transplant recipients.
  • To discuss diagnostic methods for post-transplant infections.
  • To highlight the importance of early diagnosis in reducing adverse outcomes.

Main Methods:

  • Review of common bacterial (enterobacteriaceae), viral (cytomegalovirus), fungal (Candida, Aspergillus), and protozoal (Pneumocystis carinii) pathogens.

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  • Discussion of diagnostic techniques including cultures, histology, cytology, serology, and polymerase chain reaction (PCR).
  • Emphasis on specialized procedures like bronchoalveolar lavage.

    • Main Results:

    • Infections are a major cause of morbidity and mortality in liver transplant patients.
    • Immunosuppression intensity directly correlates with infection frequency.
    • Common pathogens include cytomegalovirus, Candida, Aspergillus, enterobacteriaceae, and Pneumocystis carinii.

    Conclusions:

    • Prompt and accurate diagnosis of infections is crucial for improving outcomes in liver transplant recipients.
    • Combining traditional methods with new technologies like PCR enhances early detection.
    • Reducing infection-related morbidity and mortality is a key goal in liver transplant care.