Infectious complications after liver transplantation

Maria Del Pilar Hernandez, Paul Martin, Jacques Simkins-Cohen

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Orthotopic liver transplantation (OLT) is the standard of care for patients with decompensated cirrhosis and for patients with hepatocellular carcinoma. More than 6000 liver transplants are performed annually in the United States. High patient and graft survival rates have been achieved in great part due to the availability of potent immunosuppressive agents. Systemic immunosuppression has rendered the liver recipient susceptible to de novo infections as well as reactivation of preexisting latent infections. Infections occurring during the first month post-OLT are usually nosocomial, donor-derived, or the result of a perioperative complication. The development of opportunistic infections (OIs) such as Aspergillus and the reactivation of latent infections such as Mycobacterium tuberculosis are more frequent 1 to 6 months posttransplant, when the net state of immunosuppression is the highest. Immunosuppressive therapy is tapered 6 to 12 months post-OLT; therefore, infections occurring during that time period and afterward generally resemble those of the general population. Screening strategies applied to determine the risk of an infection after transplantation and the use of prophylactic antimicrobial therapy have reduced the incidence of OIs after OLT. This article will review the various causes of infection post-OLT and the therapies used to manage complications.

Original languageEnglish (US)
Pages (from-to)741-753
Number of pages13
JournalGastroenterology and Hepatology
Volume11
Issue number11
StatePublished - Nov 1 2015

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Keywords

  • Graft survival
  • Immunosuppression
  • Infection
  • Mortality
  • Orthotopic liver transplantation

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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