[Early postoperative infections after liver transplantation--pathogen spectrum and risk factors]

Infections occurring during the early postoperative phase after liver transplantation result in a significant rise in morbidity and mortality. The records of 279 orthoptic transplantations performed in 248 patients were analyzed retrospectively. 55.6% of all patients suffered from one or more episodes of bacterial and/or fungal infection during their postoperative hospitalisation. The median onset of bacterial/fungal infection was on day 7 after transplantation. Enterococci (42 episodes), Pseudomonas aeruginosa (38 episodes), staphylococci (37 episodes), Escherichia coli (17 episodes) and Candida albicans (11 episodes) were the most frequently detected organisms. 74 (29.8%) patients developed viral infections. 20 patients (8.1%) showed infection with cytomegalovirus (CMV), 32 patients (12.9%) with herpes simplex virus (HSV) and 6 patients (2.4%) with varicella zoster virus (VZV). 14 patients (5.6%) developed infection with both CMV and VZV. Triple infection with CMV, HSV and VZV occurred in one patient. Statistical analysis of potential risk factors showed a significant influence of blood volume replacement (p < 0.001) and occurrence of at least one rejection period (p < 0.02) for major bacterial/fungal infection and immunosuppression (p < 0.001), cold ischemic time (p < 0.04), occurrence of at least one rejection period (p < 0.005) and blood volume replacement (p < 0.04) for viral infection.