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Abstract
Liver transplantation (LTx) has emerged over the past decades as the treatment of choice for patients with end stage liver disease. Survival after liver transplantation has improved over years due to advances in surgical techniques and reduction in allograft rejection. Despite measures such as the use of protective barriers, antimicrobial prophylaxis, and vaccination, post operative infection is still considered a major cause of morbidity and mortality after liver transplantation. The objective of this study is to evaluate the effect of post LTx infection on the outcome of living donor liver transplantation (LDLT) regarding morbidity and mortality, and also to identify the possible risk factors for these infections. This study included 100 Egyptian patients with post hepatitic cirrhosis who underwent LDLT. Patients were divided according to the development of post operative infections into 2 main groups; GroupA: patients who didn{u2019}t suffer any type of infection during the early post operative period (1st month), group B: patients who suffered post LTx infection in the same period. According to the type of infection whether bacterial, viral and fungal this group was further sub divided into 3 subgroups. The rate of early complications and mortality were significantly higher among the group who developed infection especially for sepsis and biliary complications (P value < 0.0001). The rate of blood and FFP transfusion and the duration of anhepatic phase were significantly higher in the group who developed infection (P value < 0.005).The presence of HCC, Size of HCC > 3cm, serum bilirubin > 4.4, fever > 37.2, and CRP > 17.5 could be considered as predictors of post operative infections by multivariate analysis logistic regression. Early post operative infections are the leading cause of morbidity and mortality in LTx. Predictors that are found to be independently associated with post LTx infection include the presence of HCC, Size of HCC > 3cm, serum bilirubin > 4.4, fever > 37.2, and CRP > 17.5