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Original Articles
Infectious Complications after Liver Transplantation according to Donor: Comparison between Orthotopic and Living Donor Transplantation
Hyun Kyun Ki, M.D.1, Jun Seong Son, M.D.4, Won Sup Oh, M.D.1, Kyong Ran Peck, M.D.1, Nam Yong Lee, M.D.2, Sung Joo Kim, M.D.3, Jae-Won Cho, M.D.3, Suk-Koo Lee, M.D.3, and Jae-Hoon Song, M.D.1
Division of Infectious Diseases1, Department of Medicine, Laboratory Medicine2, and Department of Surgery3, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Infectious Diseases4, Choongbuk University Hospital, C
Vol.36 Num.3 (p139~148)
Background:Living donor liver transplantation (LDLT) has been performed more frequently to circumvent the shortage of donor organs. However, infectious complications after LDLT compared with orthotopic liver transplantation (OLT) have not been well investigated to date.
Methods:We have retrospectively reviewed the medical records of all consecutive cases of liver transplantation, which had been performed at the Samsung Medical Center, Seoul, Korea, from May 1996 to August 2003.
Results:Of the 284 patients enrolled, 188 (66.2%) underwent LDLT. Overall incidence of infectious complications after liver transplantation was 67.0% (191/284). Incidence of infections was not different between OLT group (67.7%) and LDLT group (67.0%) (P=0.9). Bacterial infections were the most common infectious complications (146 cases) followed by viral infections (32 cases), fungal infections (26 cases), and tuberculosis (4 cases). Enterococcus spp. (16.2%) were the leading pathogens followed by Staphylococcus aureus (15.1%) and coagulase-negative staphylococci (13.4 %). However, the distribution of etiologic agents was not different between OLT and LDLT group. Intra-abdominal infections (83 cases) were the most common type of infectious complications, which were more frequent in LDLT group (34.0%) than in OLT group (19.8%) (P=0.01).
Conclusion:LDLT resulted in intra-abdominal infections more frequently than OLT. Enterococcus spp., especially vancomycin-resistant enterococci, are emerging pathogens in patients with liver transplantation.
Keywords : Infectious complications, Living donor liver transplantation, Orthotopic liver transplantation