#Early complications in adult liver transplant recipients at the Wits Donald Gor-don Medical Centre, South Africa

 

https://ajgh.journals.ekb.eg/article_209586.html

Authors:

1. Sheetal Chiba (MBBCh, FCP(SA), MMed (Wits))¹

2. Warren Lowman (MBBCh, MMed (Wits), FC Path (SA))²

3. Gunter Schleicher (MBBCh, FCP(SA), MMed (Wits), Cert   Pulmonology (SA), FCCP)³.

Author institutions:

(1) University of the Witwatersrand, Department of Internal Medicine, Johannesburg, South Africa

(2) Vermaak and Partners/ Pathcare Pathologists, Johannesburg, South Africa: Wits Donald Gordon Medical Centre Parktown, South Africa

(3) Wits Donald Gordon Medical Centre ICU, Parktown, South Africa.

DOI: 10.52378/hmer7639

Corresponding Author:

Sheetal Chiba

Email: sheetalchiba@yahoo.com.

Received: March 23, 2020.

Peer-review started: April 1, 2020.

First decision: April 10, 2020.

Revised: May 12, 2020.

The second round of peer review, copyediting, and proofreading (by journal

editors): June 2020.

Accepted: June 29, 2020.

The article in press: July 7, 2020.

First online: July 12, 2020.

Informed consent statement: Informed consent was obtained from the patients.

Conflict-of-interest statement: All authors declare no conflict-of-interest related to this article.

Abstract

Background

Deceased donor liver transplantation (DDLT) is a transplant modality performed routinely in adults at Wits Donald Gordon Medical Centre (WDGMC). Infection, graft dysfunction, surgical and medical complications are common in the early post-transplant period, accounting for early15 morbidity and mortality.

Objectives

To provide a descriptive analysis of all complications in the first 30 days post DDLT.

To investigate associations between recipient demographic data, comorbid diabetes, MELD score, and subsequent complications.

Methods

A retrospective review of adult DDLT recipients for the first 30 days post-transplant was performed at WDGMC from January 2015 - December 2016. Fischer's exact test was used to assess relationships between demographic data and infectious complications, while an independent sample t-test was used for non-infectious complications.

Results

Seventy-eight DDLTs were performed, with 6 (8%) mortalities in the first 30 days. The median age was 54 years; 54% were male. In total, 24 recipients (31%) developed infectious complications. Sixteen patients (67% of the infectious cohort) had intra-abdominal sepsis, 6 (25%) developed lower respiratory tract infections, 6 (25%) skin and soft tissue infections, and 3 (13%) urinary tract infections. Of all infectious complications, seven patients (29%) developed bacteremia. Non-infectious complications were developed in 55 patients (71%); renal complications were more common (67%). There was no significant association between age, gender, ascites, diabetes mellitus, MELD score, and complications.

Conclusion

Non-infectious complications were more prominent than infectious complications in adult recipients in the first 30 days post-DDLT. There was no significant association between recipient demographic data, comorbid diabetes, CMV status, and MELD score.