论文部分内容阅读
Background: Infections still represent the main factors influencing morbidity and mortality following liver transplantation. This study aimed to evaluate the incidence and risk factors for infection and survival after liver transplantation.Methods: We retrospectively examined medical records in 210 liver recipients who underwent liver trans- plantation between April 2015 and October 2017 in our hospital. Clinical manifestations and results of pathogen detection test were used to define infection. We analyzed the prevalence, risk factors and prog- nosis of patients with infection. Results: The median follow-up was 214 days; the incidence of infection after liver transplantation was 46.7% ( n = 98) which included pneumonia (43.4%), biliary tract infection (21.9%), peritonitis (21.4%) and bloodstream infection (7.6%). Among the pathogens in pneumonia, the most frequently isolated was Acinetobacter baumanii (23.5%) and Klebsiella pneumoniae (21.2%). Model for end-stage liver disease (MELD) score (OR = 1.083, 95% CI: 1.045–1.123; P < 0.001), biliary complication (OR = 4.725, 95% CI: 1.119–19.947; P = 0.035) and duration of drainage tube (OR = 1.040, 95% CI: 1.007–1.074; P = 0.017) were inde- pendent risk factors for posttransplant infection. All-cause mortality was 11.0% ( n = 23). The prognostic factors for postoperative infection in liver recipients were prior-transplant infection, especially pneumo- nia within 2 weeks before transplantation. Kaplan-Meier curves of survival showed that recipients within 2 weeks prior infection had a significantly lower cumulative survival rate compared with those without infection (65.2% vs. 90.0%; hazard ratio: 4.480; P < 0.001). Conclusions: Infection, especially pneumonia within 2 weeks before transplantation, complication with impaired renal function and MELD score after 7 days of transplantation was an independent prognostic factor for postoperative infection in liver transplant recipients.