Microbiological findings of culture-positive preservation fluid in liver transplantation.

S. Janny, F. Bert, F. Dondero, F. Durand, P. Guerrini, P. Merckx, M.H. Nicolas-Chanoine, J. Belghiti, J. Mantz, C. Paugam-Burtz. Microbiological findings of culture-positive preservation fluid in liver transplantation. Transpl Infect Dis 2010. All rights reserved Abstract: Bacterial and fungal infections are the leading cause of mortality in liver transplant (LT) recipients. Few studies have examined the incidence of culture-positive preservation fluid (PF) and the outcome of related recipients. The aim of this study was to determine the incidence and the microbiologic findings of PF positive cultures, and to evaluate the impact on morbidity and mortality of LT recipients. A retrospective analysis of PF cultures performed after 477 LTs from cadavaric grafts between January 2001 and February 2008 was conducted. Forty-five (9.5%) PFs were found to be positive with 1 or 2 pathogens. The demographic profiles of recipients of PF with positive or negative cultures were similar. Enterobacteriaceae species were the most frequent organisms (n=30), followed by Staphylococcus aureus (n=5), coagulase-negative staphylococci (n=5), enterococci (n=4), and yeasts (n=3). Mortality rate at 1 month was not significantly different in recipients with positive or sterile PF cultures (88.1% vs. 87.7%, respectively). The rate of bacteremia among LT recipients with positive or negative PF cultures was not statistically different. Systemic infections caused by the pathogen cultured from the PF occurred in 8 (18%) of the 45 recipients, including bacteremia (4/8) or intra-abdominal sepsis (5/8). Causative organisms were Enterobacteriaceae species (n=5), Candida species (n=2), and Enterococcus faecium (n=1). Among the 8 patients who developed infection with the PF organism, 4 (50%) died in the intensive care unit (ICU) vs. an ICU mortality rate of 8% (3/37) in those who did not develop infection with the PF organism (P