Liver-biopsy-related infection in liver transplant recipients: A current matter of concern?

Liver Transplantation

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Liver Transplantation

C. López MD^1,*, J. Gavaldà PhD¹, I. Bilbao PhD², L. Castells PhD³, A. Gelabert MD⁴,  H. Allende PhD⁵, A. Pahissa PhD¹, O. Len PhD¹

DOI: 10.1002/lt.23817

©2014. American Association for the Study of Liver Diseases

Publication History
Accepted manuscript online: 7 JAN 2014 04:49AM EST
Manuscript Accepted: 22 DEC 2013
Manuscript Revised: 4 DEC 2013
Manuscript Received: 6 OCT 2013

Keywords: prophylaxis;  transjugular biopsy;  sepsis;  transplantation;  albumin

Abstract

Data from published studies regarding risk factors for liver-biopsy related infectious complications in liver transplant recipients are inconsistent. We carried out a retrospective cohort study analyzing consecutive liver biopsies in orthotopic liver transplant patients in a tertiary hospital (2001-2011), including 667 liver biopsies (575 percutaneous and 92 transjugular) in 286 liver transplant recipients. There were 20 complications in 19 patients (overall incidence 3.0%), 10 of which were infectious complications: 8 cases of bacteraemia, and 2 peritonitis. The causal microorganisms, were mainly Pseudomonas aeruginosa (4 patients) and Enterobacteriaceae (4 patients). All complications occurred in biopsies performed in patients hospitalized for more than 48 hours (381 biopsies in 201 patients); hence, only this group was included in the risk factor analysis. The variables associated with the development of infectious complications after liver biopsy were the presence of impaired biliary drainage at the time of biopsy (40% vs 15.1%, p=0.03) and low albumin levels (2.4 mg/dL vs 3.1 mg/dL p=0.01). In conclusion, based on our experience, infectious complications secondary to liver biopsy in liver transplant recipients are related to hospitalization at the time of biopsy, particularly in the presence of impaired biliary drainage and low albumin levels. Liver Transpl , 2013. © 2013 AASLD.

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