Infections Are Common Among Older Liver Transplant Patients

Infections following liver transplantation (LT) are common among patients age 65 years or older, according to a recent study. The risk for infection is especially high in the early post-LT period.

Findings from the study were presented at ID Week 2017, which is taking place from October 4-8, 2017, in San Diego, California.
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Many patients who receive LT are age 65 years or older. Infections are the leading primary and contributory cause of death among these patients, according to data from the United Network for Organ Sharing.

For their study, the researchers evaluated 255 patients age 65 years or older who had received primary LT from January 1, 2010, to June 30, 2015.

The researchers defined severe infection as the presence of sepsis, septic shock, or sepsis with multi-organ failure. Data on patient demographics, comorbidities, transplant data, infection event within 200 days of LT, and mortality were collected and analyzed.

Results indicated that 274 infections had occurred in 127 patients (50%), of whom 63 (25%) developed 1 infection and 64 (25%) developed 2 or more infections. The researchers noted that the median time to first infection following LT was 26 days and that 182 (66%) infections had occurred within 90 days after LT.

A total of 40 patients (31%) developed severe infections. A total of 61% of infections were bacterial, 22% were viral, and 7% were fungal. Additionally, the researchers recorded 35 (13%) opportunistic infections.

“Infections are common in this older LT cohort and occurred mainly in the early post-LT period,” the researchers concluded. “[Opportunistic infections] were infrequent except for [Cytomegalovirus]. Despite concerns for immunosuppression and immunosenescence, the outcome of infection within the 200 days of LT was overall favorable.”

—Christina Vogt

Reference:

Malinis M, Ngo T, Garcia-Diaz J, et al; the American Society of Transplantation Infectious Diseases Community of Practice. A multicenter study on clinical outcomes of infections within 200 days of liver transplantation among recipients age 65 years and older. Paper presented at: ID Week 2017; October 4-8, 2017; San Diego, CA. https://idsa.confex.com/idsa/2017/viewsessionpdf.cgi.