Transplantation has been established as accepted therapy for end-stage liver diseases for nearly 30 years. Although survival rates have insistently improved during the past decade, infections still represent a major cause of morbidity and mortality after liver transplantation.

Up to 80% of liver recipients have at least one infection during the first year after the transplantation Moreover, throughout the initial three years following the transplantation opportunistic infections are considered to be a leading cause of mortality.

Identification of risk factors for possible post-transplant infections is necessary to establish the optimal use of strategies to prevent infections in the post-transplant setting such as;

- latent or unrecognized infection of donor or recipient before transplantation
- pre-transplant colonisation of liver transplant recipients with multi drug resistant (MDR) microorganisms such as MRSA, VRE, ESBL positive enterobacteriaceae and non-albican candida
- surgical complications of the transplant operation such as prolonged operative time (>12 hours) reoperation, patients who had undergone Roux-en-Y biliary anastomosis.

Timetable Of Infections
With relatively standardized immunosuppressive regimens in clinical practice, different infectious processes tend to occur at specific times during the post-transplant course.

First Month
Most of the infections occurring in this period are nosocomial infections which are also seen after other complicated abdominal surgical operations.

1 to 6 Months (opportunistic period)
Infections caused by CMV, EBV and Aspergillus present clinically during the “opportunistic” period characterized by intense immunosuppression.

After 6 Months
Infections occurring in this period can categorized under three headings

1. Community-acquired infections
2. Chronic and/or progressive viral infections with HBV, HCV, CMV, EBV, and papillomavirus
3. Opportunistic infections due to intense immunosuppression because of allograft rejection and dysfunction