Evaluation of Clinical Characteristics and Outcomes of Postoperative
Infections in Living Liver Donors
Abstract
Aim: To analyze developing infections after living donor hepatectomy
(LDH) in living liver donors (LLDs). Methods: Demographic and clinical
charecteristics of 1106 LLDs were retrospectively analysed in terms of
whether postoperative infection development. Therefore, LLDs were
divided into two group: with (n=190) and without (n=916) antimicrobial
agent use. Results: The median age was 29.5 (min-max: 18-55). A total of
257 (23.2%) infection attacks (min-max: 1-8) was developed in 190
(17.2%) LLDs. The patients with infection that were longer intensive
care unit (ICU) and hospital stays, higher hospital admissions,
emergency transplantation, invasive procedures for ERCP, PTC biloma and
abscess drainage, and the presences of relaparatomies and transcystic
catheters. Infection attacks derived from a 58.3% hepatobiliary system,
13.2% urinary system, 6.6% surgical site and 5.8% respiratory system.
The most common onset symptoms were fever, abdominal pain, nausea and
vomiting. A total of 125 positive results was detected from 77 patients
with culture positivity. The most detected microorganisms from the
cultures taken are Extended-Spectrum β-lactamases (ESBL) producing
Klebsiella pneumonia (16.8%) and Escherichia coli (16%),
Methicillin-Resistant Staphylococcus aureus [(MRSA) (9.6%)],
Methicillin-susceptible Staphylococcus aureus [(MSSA (9.6%)] and
Pseudomonas aeruginosae (8.8%), respectively. The average number of ICU
hospitalization days was 3±2 (min 1-max 30, IQR:1) and hospitalization
days was 14±12 (min 3-max 138, IQR: 8). All infection attacks were
successfully treated. No patients died due to infection or another
surgical complication. Conclusion: Infections commonly observed infected
biloma, cholangitis and abscess arising from the biliary system and
other nosocomial infections are the feared complications in LLDs. These
infections should be managed multidisciplinary without delay and
carefully.