Related Experiment Video

Updated: May 2, 2026

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Published on: May 7, 2015

Spectrum of pathogens in native liver, bile, and blood during pediatric liver transplantation

Nagoud Schukfeh¹, Judith M Doerner, Evelyn Heintschel von Heinegg

¹Division of Paediatric Surgery, Department of General-Visceral and Transplant Surgery, University Hospital, University Duisburg-Essen, Essen, Germany.

Pediatric Transplantation

|March 7, 2014

Abstract:

During LTX, there may be a risk that pathogens of the native liver are released into the systemic circulation. No investigations on incidence/spectrum of pathogens in native livers have been published. We hypothesized that pathogens are found in the native liver of a large proportion of pediatric patients during LTX and investigated the microbiology of native livers. These data may help optimize antibiotic therapy. Twenty-two consecutive pediatric patients (median age 14 months, range, 5 months-15 yr) receiving LTX in our department from October 2010 to October 2011 were included in this prospective study. Tissue and bile were collected from the explanted liver and were cultivated on different media. All liver tissues were investigated using a broad-range PCR (SepsiTest(®)). In 16 patients, blood cultures were collected post-transplantation. Eleven patients (50%) had at least one pathogen detected; nine of these patients had an underlying diagnosis of biliary atresia. SepsiTest(®) was positive in seven patients. In four patients it was the only test detecting any pathogen. In detail, the positivity rate for liver tissue in all patients was 41% (n = 9); for bile 25% (n = 3); and for blood 25% (n = 4). Thirteen different pathogens (69% bacterial, 31% fungal) were isolated. A highly-sensitive broad-range PCR appears to be an effective method to detect pathogens in native livers of patients undergoing LTX. A high number and variety of microbes, including a high proportion of fungal pathogens, were detected.

Insights

Pathogens are frequently found in the native livers of pediatric patients undergoing liver transplantation (LTX). A broad-range PCR detected diverse microbes, including fungi, in 50% of patients, aiding antibiotic therapy optimization.

Area of Science:

Hepatology
Microbiology
Transplant Surgery

Background:

Liver transplantation (LTX) carries a risk of native liver pathogen release into circulation.
Limited data exist on the incidence and spectrum of pathogens within native livers before LTX.
Understanding native liver microbiology is crucial for optimizing peri-transplant antibiotic strategies.

Purpose of the Study:

To investigate the prevalence and types of pathogens in native livers of pediatric patients undergoing LTX.
To evaluate the utility of broad-range PCR for pathogen detection in this context.
To inform antibiotic stewardship in pediatric liver transplant recipients.

Main Methods:

Prospective study of 22 pediatric patients undergoing LTX.
Collection and cultivation of explanted liver tissue and bile samples.
Broad-range PCR (SepsiTest®) analysis of liver tissues.
Post-transplant blood cultures in 16 patients.

Main Results:

Pathogens were detected in 50% of patients (11/22); biliary atresia was common in positive cases (9/11).
Broad-range PCR identified pathogens in 7 patients, being the sole positive method in 4.
Positivity rates: liver tissue 41%, bile 25%, blood cultures 25%.
Thirteen distinct pathogens isolated (69% bacterial, 31% fungal).

Conclusions:

A significant proportion of pediatric patients harbor pathogens in their native livers prior to LTX.
Highly sensitive broad-range PCR is effective for detecting diverse pathogens, including fungi, in native liver explants.
These findings support the need for tailored antibiotic protocols in pediatric liver transplantation.

Read full analysis

Keywords:

E. coli blood culture cholangitis deceased donor liver transplant living donor multiplex PCR pediatric surgery

More Related Videos

Human Liver Spheroids from Peripheral Blood for Liver Disease Studies

Human Liver Spheroids from Peripheral Blood for Liver Disease Studies

Published on: January 27, 2023

"Liver-on-a-Chip" Cultures of Primary Hepatocytes and Kupffer Cells for Hepatitis B Virus Infection

"Liver-on-a-Chip" Cultures of Primary Hepatocytes and Kupffer Cells for Hepatitis B Virus Infection

Published on: February 19, 2019

Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...

Diseases of the Liver and Gallbladder

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...

Hepatitis

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.

Pharmacokinetics in Pediatric Patients: Drug Metabolism

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...

Kidney Transplant I: Introduction

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...

Tissue Transplantation

Tissue Transplantation

Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...

Articles linked to this work by shared authors, journal, and citation graph.

Correction: Online characterisation of oxidative potential and reactive oxygen species of fresh and aged aircraft turbine and ship engine particulate emissions.

Environmental science: atmospheres·2026

Online characterisation of oxidative potential and reactive oxygen species of fresh and aged aircraft turbine and ship engine particulate emissions.

Environmental science: atmospheres·2026

Tet-ON and Tet-OFF regulation in hypervirulent Klebsiella pneumoniae.

Microbiology spectrum·2026

stackPredAMR-a stacked random forest approach improves AMR phenotype prediction for multiple species and antimicrobial agents.

Bioinformatics advances·2026

Establishing an EU-compliant diagnostic facility for infectious diseases under war conditions in Poltava, Ukraine.

Frontiers in public health·2026

Compound-Resolved VOC Dynamics in a Full-Scale Medium-Density Fibreboard Dryer: Process-State Screening Across Wood Furnish, Amino Resin Dosing, and Thermal Operating Variables.

Polymers·2026

See all related articles