Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 026] PRESERVATION FLUID CONTAMINATION SCREENING AS PROPHYLAXYS OF THE DONOR-DERIVED MULTIDRUG-RESISTANT ORGANISMS INFECTIOUS COMPLICATIONS IN LIVER TRANSPLANT RECIPIENT
Denis EFIMOV 1, Larisa KUZMENKOVA 2, Sergey KOROTKOV 1, Aleksandr DZYADZKO 2, Aliaksei SHCHERBA 1, Oleg RUMMO 1
1 Transplantation, Minsk Scientific And Practical Center for Surgery, Transplantatology And Hematology, BELARUS, 2 ICU And Anesthesiology, Minsk Scientific And Practical Center for Surgery, Transplantatology And Hematology, BELARUS
Background : Bacterial infections are a frequent problem in deceased donors and, although there is only a low rate of donor-to-recipient transmission, significant morbidity and mortality may result when it occurs, particularly in multidrug resistant organisms (MDRO). The aim was to analyze different risk factors of bacterial complications following liver transplantation (LT) and to assess effectiveness its prevention strategy
Methods : A systemic analysis of 15-years’ (2008-2023) experience of 1000 patients after LT was performed. The association of bacterial complications (HCAI) with different factors, including preservation fluid (PF) contamination, was assessed. A routine prospective analysis of liver PF during back-table was introduced. Within 24 h, if bacterial growth is detected, the MALDI-ToF analysis with additional PCR-test for the resistance genes (RG) detection (in MDRO cases) was performed. Thus, within 48 h after organ retrieval, the PF pathogen, sensitivity and RG were detected and rational antimicrobic therapy was adopted.
Results : The overall hospital mortality after LT was 9.3% (urgent LT in 10.7% cases). The HCAI rate was 22.2%. The combined frequency of contamination of the donor organ and the recipient was 9,85%; Transmission rate - 29%; sepsis developed in 8% of all HCAI cases with mortality rate in MDRO septic recipients - 70%. The main HCAI risk factors were: MELD, PF MDRO contamination, severe early graft dysfunction, bloodloss, warm ischemia time.
Conclusions : MDRO contamination of the PF increases the risk of bacterial complications after LT. Donor contamination screening, vigorous infection control management and antibiotic stewardship are still the main measures to solve the problem.
Methods : A systemic analysis of 15-years’ (2008-2023) experience of 1000 patients after LT was performed. The association of bacterial complications (HCAI) with different factors, including preservation fluid (PF) contamination, was assessed. A routine prospective analysis of liver PF during back-table was introduced. Within 24 h, if bacterial growth is detected, the MALDI-ToF analysis with additional PCR-test for the resistance genes (RG) detection (in MDRO cases) was performed. Thus, within 48 h after organ retrieval, the PF pathogen, sensitivity and RG were detected and rational antimicrobic therapy was adopted.
Results : The overall hospital mortality after LT was 9.3% (urgent LT in 10.7% cases). The HCAI rate was 22.2%. The combined frequency of contamination of the donor organ and the recipient was 9,85%; Transmission rate - 29%; sepsis developed in 8% of all HCAI cases with mortality rate in MDRO septic recipients - 70%. The main HCAI risk factors were: MELD, PF MDRO contamination, severe early graft dysfunction, bloodloss, warm ischemia time.
Conclusions : MDRO contamination of the PF increases the risk of bacterial complications after LT. Donor contamination screening, vigorous infection control management and antibiotic stewardship are still the main measures to solve the problem.
SESSION
E-poster
E-Session 03/21 ALL DAY