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Bloodstream infections common among liver transplant recipients
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SAN DIEGO — Bloodstream infections were found to be a common complication among liver transplant recipients post-transplantation, according to a poster at IDWeek 2015.
Using the 2004 to 2012 Healthcare Cost and Utilization Project State Inpatient databases, researchers, including Carlos A. Q. Santos, MD, director of the infectious disease clinic, Washington University School of Medicine, St. Louis, gathered data of 7,912 adult liver transplant recipients from 24 transplant centers in California, Florida and New York. Data on demographics, comorbidities, bloodstream infection (BSI), mortality during hospitalization following transplant and any subsequent readmission were evaluated and retrospectively examined, to determine the incidence of BSI after liver transplantation.
Carlos A. Q. Santos
“Multilevel Cox regression models with random effects by transplant center were used to determine factors associated with BSI and death,” the researchers wrote.
Overall, the incidence of BSI after liver transplantation was 29%, with a range of 19% to 40% across all of the transplant centers (n = 2,298). Among hospitalizations where BSI was identified, 55% of recipients also had intra-abdominal infections, 37% had pulmonary infections and 22% had urinary tract infections.
BSI was associated with transplant failure/rejection (adjusted hazard ratio [aHR] = 2.6), post-transplant laparotomy (aHR = 1.4), increasing age (aHR = 1.1 year per decade) and female gender (aHR = 1.1).
Of all the patients, 15% died (n = 1,180). Multiple analyses showed mortality to be associated with BSI (aHR = 4.7), as well as transplant failure or rejection (aHR = 1.4), post-transplant laparotomy (aHR = 1.4), increasing age (aHR = 1.1 year per decade), HCV-related cirrhosis (aHR = 1.2) and prior solid-organ transplant (aHR = 1.4).
In a cost analysis, the median 1-year cumulative hospital costs among patients who developed BSI within 1-year post-transplant was higher ($661,533) compared with patients who did not develop BSI ($344,766; P < .001).
The researchers concluded: “BSI is a common and costly complication after liver transplantation, and is associated with a nearly fivefold increased risk of death.”
Reference:
Santos CAQ, et al. Abstract 1190. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.
Disclosures: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.