Management and Outcome of Liver Abscesses After Liver Transplantation
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Liver abscess after orthotopic liver transplantation (OLT) is a rare, life-threatening complication. The aim of this study is to analyze the incidence, risk factors, clinical manifestations, treatment and outcomes of liver abscesses after OLT.
We perform a retrospective review of the patients who developed one or more liver abscesses among a series of 984 patients who underwent OLT between January 2000 and December 2016.
Fourteen patients (1.5%) developed 18 episodes of liver abscesses, and the median time from OLT to the diagnosis of liver abscess was 39.7 months. Major predisposing factors were biliary strictures in 11 patients, hepatic artery thrombosis in 8, re-OLT in 3, choledochojejunostomy in 2, living donor OLT in 2, donor after cardiac death in 1, split liver in 1, and liver biopsy in 1. All patients were managed by intravenous antibiotics; percutaneous drainage was performed in 10 patients, while 2 patients underwent re-OLT. The mortality rate related to liver abscesses was 21.4%. The mean hospital stay was 30 ± 19 days, and during a mean follow-up of 93 ± 78 months, three other patients died.
Liver abscesses must be managed with antibiotic therapy and percutaneous drainage, but when these conservative measures fail (persistent abscess and sepsis), a re-OLT must be performed in order to prevent the high mortality associated with this severe complication.
Alanine amino transferase
Aspartate amino transferase
Cold ischemia time
Donation after cardiac death
Gamma glutamyl transferase
Hepatic artery thrombosis
International standardized ratio
Living donor liver transplantation
Orthotopic liver transplantation
Intensive care unit
Right upper quadrant
White blood cells
Warm ischemia time
IJA and CJ-R participated in research design and wrote the paper, AMM participated in data collection, OC participated in research design and data collection, JCP and FCM participated in the performance of the research, and AM participated in data analysis.
Compliance with ethical standards
Conflict of interest
The authors of this manuscript have no conflicts of interest.
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