Distribution characteristics of pathogens and influencing factors analysis of infections within 90 days after liver transplantation
10.12464/j.issn.1674-7445.2025294
- VernacularTitle:肝移植术后90天内感染的病原体分布特征及影响因素分析
- Author:
Huabin PENG
1
;
Haofeng XIONG
1
;
Fei HOU
1
;
Shuang ZHAO
1
;
Yizhi ZHANG
1
;
Tingting CUI
1
;
Zhiying HE
1
;
Jingyi LIU
1
;
Liying SUN
2
Author Information
1. Department of Severe Hepatopathy, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China.
2. Department of Severe Hepatopathy, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China;null;null;null.
- Publication Type:OriginalArticle
- Keywords:
Liver transplantation;
Infection;
Pathogen distribution characteristic;
Immune indicator;
Sarcopenia;
Model for end-stage liver disease score;
Child-Pugh score;
Lymphocyte subset
- From:
Organ Transplantation
2026;17(2):212-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the distribution characteristics of pathogens causing infections within 90 days after liver transplantation and the influencing factors of infection. Methods Clinical data of 176 recipients who underwent liver transplantation at the Liver Transplant Center of Beijing Friendship Hospital Affiliated to Capital Medical University from September 2021 to August 2024 were retrospectively analyzed. Patients were divided into the infection group (n=124) and the non-infection group (n=52) based on whether they developed infection within 90 days after transplantation. The distribution characteristics of pathogens in infected patients were analyzed. Univariate and multivariate logistic regression analyses were used to explore the influencing factors of infection. Results Among the 176 liver transplant recipients, 124 cases developed 243 episodes of 518 bacterial, fungal, viral or mycoplasma infections within 90 days after transplantation, with an overall infection rate of 70.5% (124/176). The composition of pathogens was mainly Gram-negative bacteria (38.6%, 200/518), followed by Gram-positive bacteria (32.2%, 167/518) and viruses (15.4%, 80/518), and fungi accounted for 13.1% (68/518). Among Gram-negative bacteria, the main pathogen was Klebsiella pneumoniae (6.8%, 35/518), and among Gram-positive bacteria, the main pathogen was Enterococcus faecalis (8.5%, 44/518). Viruses included Epstein-Barr virus (3.7%, 19/518) and cytomegalovirus (3.7%, 19/518), and fungi were mainly Candida albicans (6.8%, 35/518). The most common infection site among the 243 episodes was pulmonary infection (42.0%, 102/243), followed by abdominal infection (22.6%, 55/243) and bloodstream infection (18.1%, 44/243). The infections mainly occurred within 2 weeks after transplantation (60.9%, 148/243). Multivariate logistic regression analysis indicated that preoperative infection within 2 weeks, a high preoperative model for end-stage liver disease (MELD) score, and preoperative sarcopenia were independent risk factors for infection within 90 days after liver transplantation (all odds ratio>1, P<0.05). After multivariate correction, the levels of CD4+T cells and CD8+T cells within 90 days after surgery were independently associated with the occurrence of infection. Low levels of CD4+T cells and CD8+T cells might be related to an increased risk of infection. Conclusions The infection rate after liver transplantation is high, and the pathogens are mainly Gram-negative bacteria. The lungs are the most common infection site. Preoperative MELD score, preoperative sarcopenia and preoperative infection within 2 weeks are independent risk factors for infection within 90 days after liver transplantation. Regular monitoring of immune indicators CD4+T cells and CD8+T cells levels after transplantation is helpful to reduce the occurrence of post-transplantation infection.
