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Mortality risk greater in LT recipients with C. difficile

Liver transplant recipients who developed Clostridium difficile infection had a greater risk for postoperative mortality compared with controls, according to new research data.

Chetan Mittal, MD, division of infectious diseases, Henry Ford Health System, Detroit, and colleagues retrospectively examined data on 970 liver transplant (LT) recipients (mean age, 53.2; 65.4% men) between 2000 and 2010. LT recipients with C. difficile infection (CDI) were compared with controls (those without CDI) and follow-up was until date of death after LT or Dec. 31, 2011. CDI was present in 3.3% of patients before transplant, while 16.7% of patients developed CDI post-transplant.

Chetan Mittal

Researchers determined the mortality rate among all patients as 27.8%, and patients with CDI had a greater mortality rate compared with controls (35% vs. 26%, P=.003).

CDI recurrence and relapse rates among patients were 16.9% and 9.7%, respectively. CDI in LT recipients within 1 year after transplantation was 12.4%, and 6.6% of patients (63/954) developed CDI 1 year after LT.

CDI was considered severe in 29% of the patients with CDI, and some required colectomy. The patients’ year of transplant (HR=1.137; 95% CI, 1.06-1.22), white race (HR=1.47; 95% CI; 1.03-2.1), MELD score (HR=1.03; 95% CI, 1.01-1.045) and length of hospital stay (HR=1.01; 95% CI, 1.005-1.02) were all independent predictors for CDI.

“A retrospective cohort study performed of Clostridium difficile infection in 970 liver transplant recipients found high prevalence (18.9%), recurrence (16.9%) and relapse rates (9.7%) and significantly higher all-cause mortality,” Mittal told Healio.com.

Researchers said the study was limited by its retrospective design and lack of strain-typing data. “Meticulous attention to infection control measures is required to reduce the rates of nosocomial transmission, which contributes to a significant number of cases,” they concluded.

Disclosure: The researchers report no relevant financial disclosures.