Epidemiology and Management of Infections in Liver Transplant Recipients

Surg Infect (Larchmt). 2024 May;25(4):272-290. doi: 10.1089/sur.2023.346. Epub 2024 May 3.

Abstract

Background: Improvements in liver transplant (LT) outcomes are attributed to advances in surgical techniques, use of potent immunosuppressants, and rigorous pre-LT testing. Despite these improvements, post-LT infections remain the most common complication in this population. Bacteria constitute the most common infectious agents, while fungal and viral infections are also frequently encountered. Multi-drug-resistant bacterial infections develop because of polymicrobial overuse and prolonged hospital stays. Immediate post-LT infections are commonly caused by viruses. Conclusions: Appropriate vaccination, screening of both donor and recipients before LT and antiviral prophylaxis in high-risk individuals are recommended. Antimicrobial drug resistance is common in high-risk LT and associated with poor outcomes; epidemiology and management of these cases is discussed. Additionally, we also discuss the effect of coronavirus disease 2019 (COVID-19) infection and monkeypox in the LT population.

Keywords: antimicrobial drug resistance; immunosuppression; post-liver transplant infections; vaccination.

MeSH terms

  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology
  • Bacterial Infections / prevention & control
  • COVID-19* / epidemiology
  • Humans
  • Liver Transplantation* / adverse effects
  • Mycoses / drug therapy
  • Mycoses / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • SARS-CoV-2
  • Transplant Recipients*
  • Virus Diseases / epidemiology
  • Virus Diseases / prevention & control