Infectious complications in pediatric patients after liver transplantation in the first 3 months at the Fundación Valle del Lili, a Latin American transplant center

• Published in: Journal of liver transplantation Vol. 15; p. 100221
• Main Authors: Camacho, Paola Marsela Pérez, Osorio, Verónica Botero, Cárdenas, Daniel Fernando Carvajal, García, María Alejandra Acevedo, Tarapués, Eliana Manzi, Torres-Cánchala, Laura, Hernández, Inés Elvira Gómez, Sandoval-Calle, Lina M., Rusca, Luis Armando Caicedo, Niño, Jaime A. Patiño
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-08-2024
• Subjects: Child; Complications; Infection; Liver transplantation; Pediatrics; Postoperative; Infection; Postoperative; Pediatrics; Complications; Child; Liver transplantation
• DOI: 10.1016/j.liver.2024.100221
• EISSN: 2666-9676

In pediatric patients undergoing liver transplantation, infections are one of the primary complications. The etiology varies depending on the time elapsed post-transplant, with early presentations of bacterial and fungal infections, followed by viral and parasitic infections. There is limited literature describing the prevalence of infectious complications in this group of patients in Colombia.
To describe infectious complications in patients undergoing liver transplantation within the first 3 months post-procedure at the Fundación Valle del Lili, Cali, Colombia.
A case series of 165 pediatric liver transplant patients during the period 2011–2017. A descriptive analysis of all entered data was conducted. Survival analysis using the Kaplan-Meier method was performed, with an exploratory analysis comparing patient survival based on the presence of infection, censored for death related to postoperative complications.
The primary diagnosis at the time of transplantation was biliary atresia in 65% of cases. A total of 215 infectious episodes were recorded in 92 pediatric liver transplants. The most frequent microorganisms were Klebsiella pneumoniae (21%), Cytomegalovirus (CMV) (7%), Pseudomonas aeruginosa (7%), Escherichia coli (6%), and Epstein Barr Virus (EBV) (6%). Three-month patient survival was 92% for infection-related mortality.
Infectious complications within the first three months post-pediatric liver transplantation were predominantly bacterial in origin. Bacterial and fungal infections manifested earlier, while viral infections appeared later. Infectious complications did not impact the three-month patient survival in this group.