Risk Factors for Surgical-site Infections After Liver Transplant: Does Perioperative Antibiotic Regimen Matter?

Area of Science:

• Transplantation Medicine
• Infectious Disease Epidemiology
• Surgical Oncology

Background:

• Surgical-site infections (SSIs) are a significant complication following liver transplantation.
• Optimal antimicrobial prophylaxis strategies for preventing SSIs in this patient population remain undefined.

Purpose of the Study:

• To investigate risk factors for SSIs in liver transplant recipients.
• To evaluate the impact of perioperative antibiotic prophylaxis spectrum on SSI development.

Main Methods:

• Retrospective analysis of adult liver transplant recipients across three centers from January 2020 to June 2021.
• Comparison of SSI rates based on narrow-spectrum versus broad-spectrum antimicrobial prophylaxis.
• Multivariable analysis to identify independent risk factors for SSIs.

Main Results:

• Of 557 patients, 7.2% developed SSIs; 30% of these involved multidrug-resistant organisms (MDROs).
• No significant association was found between the spectrum of antimicrobial prophylaxis and SSI risk (P=0.5).
• Surgical leak (P<0.001) and reoperation (P=0.017) were independently associated with increased SSI risk.

Conclusions:

• The spectrum of antimicrobial prophylaxis does not influence the incidence of SSIs in liver transplant recipients.
• Focusing on surgical technique and managing complications like leaks and reoperations may be more critical for SSI prevention.