Clinical Significance of Contamination of the Preservation Solution in Liver Transplantation

Area of Science:

• Hepatology
• Transplant Surgery
• Microbiology

Background:

• Liver transplantation (LT) involves using preservation solution (PS) for organ viability.
• Assessing the microbiological profile of PS is crucial for understanding potential post-transplant complications.

Purpose of the Study:

• To determine the incidence and microbial characteristics of positive preservation solution (PS) cultures.
• To correlate PS culture findings with infectious complications in liver transplant (LT) recipients.

Main Methods:

• A retrospective, single-center study was conducted involving 178 LT recipients from December 2010 to August 2014.
• Preservation solution (PS) cultures were performed on all grafts.
• Postoperative infections were monitored until hospital discharge, with the most severe infection classified using the Clavien-Dindo system.

Main Results:

• Positive PS cultures for bacterial or fungal agents were found in 79 out of 178 LT recipients (44%).
• The most frequent microorganisms identified were coagulase-negative staphylococci (64%), Enterobacteriaceae (17%), and Staphylococcus aureus (4.7%).
• Only 5% (4 out of 79) of patients with PS contamination developed postoperative infections linked to the isolated microorganisms.

Conclusions:

• A high percentage of liver grafts exhibit PS contamination prior to LT.
• There is a weak correlation between PS contamination and the development of postoperative infections in LT recipients.
• Implementing standardized fungal and bacterial cultures for PS may be beneficial for patient management.