Preliminary Analysis of Contamination in Liver Preservation Solution and Prophylaxis for Post-transplant Infection

Abstract

Objective To discuss the preservation solution (PS) contamination and initial experience of liver transplantation from organ donation by citizens after death and initial experience. Methods The 78 liver transplant recipients were divided into positive group and negative group based on the finding of the culture of PS. The positive group received the sequential therapy of antibiotics with ertapenem and imipenem for one week, and the negative group stopped using imipenem. The situation of PS contamination and infection after liver transplantation and prognosis during the follow-up 3 months of the recipients were analyzed. Results PS culture positive rate was 41.03%, and 33 strains of pathogens were isolated. The most common pathogenic bacteria were gram-negative bacilli (9 strains, 27.27%) and coagulase –negative staphylococci (9 strains, 27.27%). The infection rate after liver transplantation was 31.25% and 13.04%, respectively, in positive group and negative group (χ2=3.837, P=0.048). The most frequent infection sites were lower respiratory tract (5 cases, 31.25%), abdominal cavity (5 cases, 31.25%) and surgical incision (4 cases, 25.00%). There was no significant difference in postoperative infection rate among patients with different CTP, MELD and surgical methods (P>0.05). One case (1.28%) was infected with the same pathogenic bacteria as PS contamination 3 weeks after liver transplantation, and died of multiple organ failure. There was no significantly difference in the acute rejection rate (1,3.13% and 2, 4.35%) and mortality (2,6.25% and 5,10.87%) between the two groups (P>0.05). Conclusion Contamination of the PS is frequent in liver transplantation, and it is the risk factor for postoperative infection of recipients. Early targeted antimicrobial treatment against pathogens cultured from PS play a positive role in reducing the contamination-associated infection rate after liver transplantation.