Evaluation of infections after abo-compatible and incompatible liver transplantations

Introduction and background: Today, liver transplantation is a unique option in acute hepatic failure and end stage liver disease. Survival rates after liver transplantations have been increased by new immunosupressive drugs, advanced surgical techniques, and developments in diagnosis, management and prevention of infections. Despite all these developments, infections remain the most common complications after liver transplantations. However, as a result of organ donation is low, the shortage of suitable donors has become the most urgent problem today. Due to a shortage of organ donation, many transplant centers have chosen to expand the criteria for organ acceptance such as ABO-incompatible liver transplantation. Although infections, rejections, and biliary complications are common after ABO-incompatible liver transplantation, it has been conducted, albeit controversial, in emergency cases. In order to make comparisons in terms of infections and survivals, ABO-compatible and incompatible liver transplant recipients were analyzed, retrospectively.Materials and methods: Sixteen ABO-incompatible liver transplant recipients who were operated by Organ Transplant Team between May 2002 and January 2011, were included in the study. One before and after of the ABO-incompatible recipients, totally 32 ABO-compatible patients, were selected as a control group. All patients? data were recorded from hospital records.Results: Thirteen (81.2%) of the ABO-incompatible liver transplant recipients were male and three (18.8%) were females; 8 (25%) of the ABO-compatible recipients were female and 24 (75%) were men (p = 0.836). The mean age of the ABO-incompatible was 46.7 ± 14.2 years (range: from 17 to 63), of ABO-compatible recipients was 45.9 ± 11.9 years (range: from 20 to71), respectively (p = 0.627).For one-year period after liver transplantation, 12 (75%) of the ABO-incompatible recipients, and 21 (65.6%) of the ABO-compatible recipients had at least one attack of infection (p=509). The infection attack rate was 175% in ABO-incompatible group, and 113% in ABO-compatible group (p=0.262). Eight (50%) of the ABO-incompatible recipients and 9 (28.1%) of the ABO-compatible recipients were died within one year of transplantation (p=0.135). There was no difference in terms of mortality and infection rates in both groups. In both ABO-compatible and incompatible recipients, Pseudomonas aeruginosa was isolated most frequently.Conclusions: Post-operative complications can be seen more in ABO-incompatible liver transplantation recipients. The results of our study showed that infection rates and survival were similar in ABO-incompatible and compatible recipients. Despite the rate of complications may be different between centers and patient groups, it has been concluded that in emergency cases to extend the donor pool, ABO-incompatible liver transplantations cases may not increase the infectious complications.Key words: ABO-incompatible and compatible liver transplantation, infection, survival.