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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Infections following solid-organ transplants are a major cause of morbidity and mortality. Management may be problematic and is often based on experience with hepatic abscess in nontransplant patients. We reviewed our experience with hepatic abscess in liver transplant recipients to assess their presentation, clinical features, treatment, and outcome. A retrospective review of of all liver transplantations at Namazi Hospital Transplant Center from September 1997 through September 2008 was performed. The follow-up period ranged from 8 months to 11 years. Diagnosis of hepatic artery thrombosis (HAT) was confirmed by angiography and liver abscess ( LA) was documented by ultrasonography. Percutaneous drainage of the abscess was performed using conventional techniques. Hepatic arterial reconstruction (if present) was performed using conventional techniques, preserving all replaced and accessory arterial vasculature. Of 560 liver recepients, we identified 4 patients who had experienced 6 episodes of hepatic abscess. Median time from transplant to hepatic abscess was 5.7 months (range 1–9 months). The predisposing factor was hepatic artery thrombosis (HAT) and bile duct anastomotic stricture, prior episodes of bacteremia (each in 1 patient). Clinical presentation of hepatic abscess was similar to that described in non-immunosuppressed patients. Drug history was the same in all patients. Pretransplant diagnoses included Hepatitis B cirrhosis, autoimmune hepatitis, Caroli’s disease and cryptogenic cirrhosis. Liver aspirates showed E.coli in 3 cases and was unknown in one case. Patients received an average of 6 weeks of intravenous antibiotic therapy. Percutaneous drainage was successful in 3 cases who had single abscess. One patient died due to internal bleeding and liver failure, although 3 times percutaneous drainage was done for him. In conclusion, hepatic abscess, a rare complication after liver transplantation, was associated with hepatic artery thrombosis and anastomosis stricture. Mortality was higher than in patients who had not undergone transplantation. Prolonged antibiotic therapy and drainage are required to improve the outcome in these patients.

Volume : 6
Issue : 4
Pages : 111

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Shiraz Transplant Center, Namazi Hospital, and Transplantation Research Center Shiraz University of Medical Science, Shiraz, Iran