Outcome of a First Episode of Bacterial Infection in Candidates for Liver Transplantation

Liver Transpl. 2019 Aug;25(8):1187-1197. doi: 10.1002/lt.25479. Epub 2019 Jul 8.

Abstract

Bacterial infection (BI) is a major cause of worsening of liver function and death in patients with cirrhosis who are awaiting liver transplantation (LT). This study aimed to evaluate the outcome of LT candidates after a first episode of BI between January 2006 and December 2014 at Padua University Hospital. Among 876 LT candidates with cirrhosis, 114 (13%) experienced an episode of BI. Of the 114 patients, 79 were male and 35 were female, and the median (interquartile range) age and Model for End-Stage Liver Disease scores were 58 (12) years and 19 (8), respectively. When compared with matched LT candidates who experienced no BI, they had a higher probability of death (P = 0.004) and a lower probability of undergoing LT (P = 0.01). Considering only patients who recovered from BI within 30 days, their probabilities of death and of undergoing LT were similar to those of matched controls (P = 0.34 and P = 0.43, respectively). The 90-day post-LT mortality was equal between groups (P = 0.90). BI was a strong predictor of early death on the waiting list for LT. Conversely, patients who fully recovered from a BI episode within 30 days did not have a higher mortality risk than matched controls without infection.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Bacterial Infections / complications
  • Bacterial Infections / diagnosis
  • Bacterial Infections / mortality*
  • Bacterial Infections / therapy
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / mortality*
  • End Stage Liver Disease / surgery
  • Female
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / mortality*
  • Liver Cirrhosis / surgery
  • Liver Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Analysis
  • Waiting Lists / mortality*