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Updated: Oct 22, 2025
Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts
Published on: August 13, 2014
Preservation fluid cultures. Clinical significance in liver transplantation
Santiago Reimondez1, María Luz Chamorro1, Álvaro Alcaraz1
1Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina.
Abstract:
The aim of this study was to determine the incidence of preservation fluids (PF) bacterial positive cultures, identify the germs involved, determine their correlation with infections in recipients during the postoperative period and compare outcomes in terms of morbidity, hospital stay and both patient and graft survival. We describe incidence and etiology of germs developed in PF cultures in our series and evaluate its impact on recipients. A prospective study in deceased donor liver transplants (LT) recipients was carried out from January 2014 to December 2017. Back table PF cultures were analized considering positive the development of any germs and negative to no signs of growth after 5 days. PF were classified as contamination or pathogens. Targeted antibiotic therapy was administered in the last ones. Recipients were divided in: PF (-) and PF(+). Recipients infections related to positive PF were analyzed. These were identified as "direct correlation" when the same germ grew up in PF. Hospital stay and 30 days follow up were compared. Eighty-eight patients PFs were included, 38% (33) had positive cultures, 28 (85%) of these were considered contamination and only 5 as pathogens. We found no differences in postoperative infections (p 0.840), ICU and total hospital stay (p 0.374 and 0.427) between both groups. Postoperative infections and hospital stay seem not to be infuenced by PF cultures positivity. Treatment of isolated pathogens could have prevented infections, therefore, those groups that perform PF cultures should consider treatment in these cases and conclude prophylaxis when PF is negative or contaminated.
Insights
Preservation fluid (PF) bacterial cultures in liver transplant recipients rarely indicate infection. Postoperative outcomes were similar regardless of PF culture results, suggesting current protocols may need adjustment.
Area of Science:
- Transplantation
- Microbiology
- Infectious Diseases
Background:
- Preservation fluids (PF) used in liver transplantation (LT) can potentially harbor bacteria.
- Assessing bacterial growth in PF is crucial for understanding its impact on recipient outcomes.
Purpose of the Study:
- To determine the incidence and types of bacteria in PF cultures from deceased donor liver transplants.
- To correlate PF bacterial growth with postoperative infections in recipients.
- To compare patient and graft survival, morbidity, and hospital stay between PF-positive and PF-negative groups.
Main Methods:
- A prospective study analyzed back table PF cultures from 88 deceased donor liver transplant recipients (Jan 2014-Dec 2017).
- Cultures were assessed for bacterial growth over 5 days, classified as contamination or pathogens.
- Recipients were grouped as PF-negative or PF-positive, with infections analyzed for direct correlation.
Main Results:
- 38% of PF cultures were positive, with 85% classified as contamination and only 5 as pathogens.
- No significant differences were observed in postoperative infections, ICU stay, or total hospital stay between PF-positive and PF-negative groups.
- No statistically significant impact of PF culture positivity on recipient infections or hospital stay was found.
Conclusions:
- Bacterial positivity in preservation fluids does not appear to significantly influence postoperative infections or hospital stay in liver transplant recipients.
- Targeted antibiotic therapy for identified pathogens in PF might prevent infections.
- Consideration should be given to adjusting prophylaxis strategies based on PF culture results, potentially discontinuing prophylaxis for negative or contaminated cultures.
