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Hepatic abscess: a rare complication after liver transplant
Oskar Kornasiewicz1, Wacław Hołówko2, Michał Grąt2
1Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. oskar.kornasiewicz@wum.edu.pl.
Clinical Transplantation
|July 14, 2016
Summary
Hepatic abscesses after orthotopic liver transplant (OLT) are rare but serious. Successful treatment combines interventional procedures with antibiotics, guided by microbial cultures, though mortality remains a concern.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- Hepatic abscess is a rare but serious complication following orthotopic liver transplant (OLT).
- Understanding predisposing factors, microbiology, and treatment outcomes is crucial for improving patient care.
Purpose of the Study:
- To evaluate predisposing factors, microbiology, treatment strategies, and outcomes of hepatic abscess after OLT.
- To identify key elements for successful management of post-transplant hepatic abscess.
Main Methods:
- Retrospective analysis of a prospectively maintained database of 1100 OLT patients.
- Hepatic abscess defined by imaging and clinical signs of infection.
- Review of treatment approaches including interventional procedures and antibiotics.
Main Results:
- 1.4% of OLT patients (15/1100) developed hepatic abscess, often multiple (80%).
- Common predisposing factors included biliary pathology, hepaticojejunostomy, and hepatic artery issues.
- Bacterial (87%) and fungal (33.3%) growth was frequent; mortality was 33.3% despite interventions.
Conclusions:
- Hepatic abscess post-OLT requires prompt diagnosis and management.
- Combined percutaneous/endoscopic intervention with targeted antibiotics improves outcomes.
- Vigilance for microbial growth and potential complications is essential.
