Evaluation of Infections Developing in Liver Transplant Patients: Thirteen-Year Experience of a Single Center

Liver transplantation is a life-saving treatment for end-stage liver disease and acute liver failure. This study examines infections that develop within 1 year after liver transplantation, their risk factors, and patient prognoses.

This study retrospectively reviewed the follow-up files and hospital computer records of patients who underwent liver transplantation at our hospital between 2010 and 2024. Patients information were recorded. After data analysis, statistical significance was accepted as p < .05.

Of the 106 patients included in the study, the mean age at transplantation was 47.61 ± 12.17 (20-67), and 56 (52.8%) were male. The most common indication for transplantation was cryptogenic liver cirrhosis (26.4%). Nineteen (17.9%) patients died within the first 48 hours after transplantation. Of the 87 patients who survived after transplantation, 68 (78.2%) experienced at least 1 episode of infection, resulting in a total of 135 infections. Intra-abdominal infection (28.1%) was the most common post-transplantation infection. In the 1-year post-transplant period, the most common infections were bacterial (57.8% Gram-negative microorganisms) in 71.5% of cases, followed by fungal (16.5%), viral (6.5%), parasitic (5.5%), and M. tuberculosis (0.9%). Klebsiella spp. was the most common bacterial agent in 32 (29.3%) cases, and carbapenem resistance was detected in 64.9%. Enterococcus spp. was the most common Gram-positive microorganism in 12 (11%) cases. The duration of surgical prophylaxis was longer in patients who did not develop infection than in patients who did (p = .014). The length of intensive care unit stays in patients who developed infection was longer than in patients who did not (p = .033). Five patients (8.9%) died due to infection.

Although bacterial infections are the most common, opportunistic viral, fungal, and parasitic infections can also occur in liver transplant patients. Because these infections can lead to patient death, rapid diagnosis and early initiation of treatment are crucial.