What are the most common infections in the early posttransplant period in liver transplant patients?

Updated: Dec 31, 2017
  • Author: Lemi Luu, MD, RDMS, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Infection in the early posttransplant period (<1 month) is most commonly bacterial, though the risk of fungal infection is high. This is the period when patients are most immunosuppressed. Infections are primarily nosocomial and are caused by the same organism seen in other surgical patients, such as enterococci, staphylococci, gram-negative aerobes, anaerobes, or candidal species (75% of fungal infections). They are frequently intra-abdominal (cholangitis, liver, and other abdominal abscesses) and are typically observed during the posttransplant hospitalization.

Infected transplant patients may present with fever, abdominal pain, or jaundice, or they may possibly be asymptomatic because of immunosuppression. A complete fever/sepsis workup that includes a complete blood count (CBC), chemistries, liver function tests, coagulation panel, urinalysis, urine culture, blood culture, and abdominal and chest radiographs should be obtained. Further studies may include computed tomography (CT), abdominal ultrasonography, T-tube cholangiography, endoscopic retrogrande cholangiopancreatography (ERCP), and liver biopsy.


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