Review
Copyright ©2011 Baishideng Publishing Group Co.
World J Hepatol. Apr 27, 2011; 3(4): 83-92
Published online Apr 27, 2011. doi: 10.4254/wjh.v3.i4.83
Table 1 Selected infections after liver transplantation
Time period after liver transplantation
1st mo
Between 1st and 6th mo
Beyond 6th mo
General risks: surgical procedure, prolonged hospitalization, prior colonization, mechanical ventilation, indwelling vascular and urinary catheterization, donor-transmitted diseases, among othersGeneral risks: over-immunosuppression, D+/R- mismatch status for viruses, allograft rejection, donor-transmitted diseases, repeated biliary tract manipulations, re-transplantationGeneral risks: variable
High-risk patients include those with recurrent rejection and allograft dysfunction that would require intense immunosuppression
Bacterial infections including resistant pathogens – bloodstream infections, pneumonia, surgical site infections, intra-abdominal infections, abscesses, urosepsis, Clostridium difficile associated colitisBacterial infections continue to occur in some patients – bloodstream infections, pneumonia, abdominal infections, C difficile associated colitisMinimal immunosuppression – usual community acquired infections and zoster
Herpes simplex virus infection – herpes labialis or genitalis with potential for disseminated diseaseOpportunistic pathogens: cytomegalovirus, Epstein-Barr virus, human herpesvirus 6 and 7, Aspergillus species, Pneumocystis jirovecii, Nocardia species, Mycobacterium tuberculosis, endemic mycoses, Toxoplasma gondii, among othersIntense immunosuppression due to allograft rejection and dysfunction – infections occurring during the opportunistic period (see middle column) continue to occur; course of chronic viral hepatitis may be accelerated
Candida sp. infections – fungemia, abscesses, urosepsis