Review
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World J Hepatol. Apr 27, 2011; 3(4): 83-92
Published online Apr 27, 2011. doi: 10.4254/wjh.v3.i4.83
Infections in liver transplant recipients
Fabian A Romero, Raymund R Razonable
Fabian A Romero, Raymund R Razonable, Division of Infectious Diseases and the William J von Liebig Transplant Center, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Romero FA and Razonable RR contributed equally to this review.
Correspondence to: Raymund R Razonable, MD, Division of Infectious Diseases Marian Hall 5, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. razonable.raymund@mayo.edu
Telephone: +1-507-2843747 Fax: +1-507-2557767
Received: October 20, 2010
Revised: December 6, 2010
Accepted: December 13, 2010
Published online: April 27, 2011
Abstract

Liver transplantation is a standard life-saving procedure for the treatment of many end-stage liver diseases. The success of this procedure may be limited by infectious complications. In this article, we review the contemporary state of infectious complications during the post-operative period, with particular emphasis on those that occur most commonly during the first 6 mo after liver transplantation. Bacteria, and less commonly Candida infections, remain the predominant pathogens during the immediate post-operative period, especially during the first month, and infections caused by drug-resistant strains are emerging. Infections caused by cytomegalovirus and Aspergillus sp. present clinically during the “opportunistic” period characterized by intense immunosuppression. As newer potent immunosuppressive therapies with the major aim of reducing allograft rejection are developed, one potential adverse effect is an increase in certain infections. Hence, it is essential for liver transplant centers to have an effective approach to prevention that is based on predicted infection risk, local antimicrobial resistance patterns, and surveillance. A better understanding of the common and most important infectious complications is anticipated to lead to improvements in quality of life and survival of liver transplant recipients.

Keywords: Bacteremia; Candidemia; Cytomegalovirus; Aspergillosis; Transplant