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John O. Colonna, II, MD; Drew J. Winston, MD; Judith E. Brill, MD; Leonard I. Goldstein, MD; Marilyn P. Hoff, RN; Jonathan R. Hiatt, MD; William Quinones-Baldrich, MD; Kenneth P. Ramming, MD; Ronald W. Busuttil, MD, PhD

Arch Surg. 1988;123(3):360-364.

Abstract
• Thirty-five patients received 42 liver homografts between February 1984 and August 1985. One or more infections developed in 23 patients (66%) some time after transplantation. An average of 2.5 infections per infected patient occurred. Of 37 bacterial infections, two thirds were either bacteremias or localized intra-abdominal infections. The median onset was 29 days after operation. Thirteen viral infections were identified, with a median onset of 18 days after operation. Nine fungal infections, six disseminated and three localized, were identified, with a median onset of nine days after operation. Infection was the primary cause of death in five (14%) of 35 patients. Fatal infections were evenly distributed among bacterial (two), fungal (three), and viral (two) pathogens. Despite advances in surgical techniques and the use of cyclosporine, infection after orthotopic liver transplantation is a serious problem. Certain patients can be identified as high risks for infection and require an aggressive diagnostic workup followed by early institution of antimicrobial therapy.

(Arch Surg 1988;123:360-364)

Author Affiliations
From the Departments of Surgery (Drs Colonna, Hiatt, Quinones-Baldrich, Ramming, and Busuttil and Ms Hoff), Medicine (Drs Winston and Goldstein), and Pediatrics (Dr Brill), UCLA—Center for the Health Sciences.

Footnotes
Accepted for publication Oct 23, 1986.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, Jan 17, 1986.

Reprint requests to Department of Surgery, Room 77-132, UCLA—Center for the Health Sciences, 10833 Le Conte St, Los Angeles, CA 90024 (Dr Busuttil).

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