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Differences Between Infectious Disease Events in First Liver Transplant Versus Retransplantation in the Swiss
Katharina Kusejko1,2, Dionysios Neofytos3, Hans H Hirsch4,5
1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Summary
Graft retransplantation in liver transplant patients shows fewer infectious disease events compared to first transplants. This suggests improved outcomes for retransplanted patients regarding infection risk.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- Liver retransplantation is increasingly common due to graft failure.
- Retransplantation is associated with poorer outcomes, but the role of infectious disease (ID) events is unclear.
Purpose of the Study:
- To analyze and compare infectious disease events after first liver transplantation (FLTpx) and liver retransplantation (reLTpx).
- To identify differences in infection types, sites, and timing between FLTpx and reLTpx.
Main Methods:
- Analysis of ID events in the Swiss Transplant Cohort Study, comparing FLTpx and reLTpx.
- Survival analysis adjusted for clinical factors (age, sex, MELD score, donor type, etc.).
- Comparison of infection types, sites, and timing between the two groups.
Main Results:
- 343 ID events observed: 204 after FLTpx and 139 after reLTpx.
- Bacterial infections were most common. Retransplantation showed more Aspergillus spp. infections but fewer Candida spp.
- Respiratory tract and surgical site infections were more frequent after reLTpx. Time to first infection was shorter after FLTpx, with overall reduced hazards for ID events after reLTpx.
Conclusions:
- While the number of infections is comparable, retransplantation exhibits distinct patterns in infection sites and fungal species.
- Reduced hazards for infectious disease events were observed after liver retransplantation compared to first liver transplantation.
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