Liver abscesses increased risk of mortality, retransplantation among LT recipients

PHILADELPHIA —Liver transplant recipients with intra-abdominal infections who develop liver abscesses after transplantation had an increased risk for mortality and possible re-transplantation, according to data presented at IDWeek 2014.

Records of liver transplant recipients from Henry Ford Hospital in Michigan between January 2003 and December 2012 (n=986) were analyzed to determine the development, risk factors and outcomes of liver abscesses after transplantation.

Of all the patients, the incidence of intra-abdominal infection was 15.3 per 100 transplant recipients and the incidence of liver abscesses was 2.4 per 100 recipients. Forty-six percent of the liver abscesses were polymicrobial infections.

Liver transplant recipients with liver abscesses had a higher all-cause mortality rate compared with recipients with only intra-abdominal infections (17% vs. 5%; P=.03), as well as higher rate of liver failure leading to retransplantation (13% vs. 3%; P=.045).

There were 37.5% of recipients with liver abscesses who died, required retransplantation due to liver failure or experienced serious complications, compared with 9% of recipients who had strictly intra-abdominal infection (P<.001).

Predictors for developing liver abscesses included evidence of abnormal hepatic artery (OR=10.51; 95% CI, 3.27-33.71) and liver failure due to nonalcoholic steatohepatitis, primary biliary cirrhosis or primary sclerosing cholangitis (OR=3.58; 95% CI, 1.27-10.10), according to logistic regression analysis.

“The evidence of hepatic artery abnormality after liver transplantation is associated with significant risk for developing liver abscesses,” researcher Ahmad Aldeiri, MD, of Henry Ford Hospital, told Healio.com/Hepatology. “Also, the mortality related to infection and liver transplant patients who develop liver abscesses was significantly higher compared to other patients who developed other intra-abdominal infections. We think close monitoring of patients who have any evidence of hepatic artery abnormality at early intervention might improve morbidity and mortality among these patients.” – by Melinda Stevens

For more information:

Aldeiri A. Abstract 441. Presented at: IDWeek, Oct. 8-12, 2014; Philadelphia, PA.

Disclosure: The researchers report no relevant financial disclosures.