Identifying a targeted population at high risk for infections after liver transplantation in the MELD era
Article first published online: 10 MAY 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 3, pages 420–425, May/June 2011
How to Cite
Sun, H.-Y., Cacciarelli, T. V. and Singh, N. (2011), Identifying a targeted population at high risk for infections after liver transplantation in the MELD era. Clinical Transplantation, 25: 420–425. doi: 10.1111/j.1399-0012.2010.01262.x
- Issue published online: 8 JUN 2011
- Article first published online: 10 MAY 2010
- Accepted for publication 11 March 2010
- D-model for end-stage liver disease;
- liver transplant;
- model for end-stage liver disease;
- post-transplant dialysis;
- post-transplant infection
Sun H-Y, Cacciarelli TV, Singh N. Identifying a targeted population at high risk for infections after liver transplantation in the MELD era. Clin Transplant 2011: 25: 420–425. © 2010 John Wiley & Sons A/S.
Abstract: Impact of model for end-stage liver disease (MELD) scoring system on post-transplant infections and associated risk factors are unknown. Infections <90 d post-transplant were assessed in 277 consecutive liver transplant recipients from 1999 to 2008. “High-risk” factors for infections were pre-defined as MELD score >30, ICU stay >48 h prior to transplant, intraoperative transfusion ≥15 units, retransplantation, post-transplant dialysis, or reoperation. Of the 240 recipients in the MELD era (2002–2008), 48.5% had any high-risk factor. The OR for infection was 1.69, 2.00, 18.00, and 4.50 in recipients with any 1, 2, 3, and ≥4 high-risk factors, respectively (χ2 for trend, p < 0.001). In logistic regression model, recipient age (OR 1.12, p < 0.05) and any high-risk factor (OR 2.42, p < 0.05) were associated with infections. Compared with 37 pre-MELD recipients, the overall infections and mortality at 12 months did not differ in the two eras. In Cox regression model, recipient age (OR 1.09, p < 0.05) and any high-risk factor (OR 2.42, p < 0.05) remained associated with infections. The overall frequency of infections did not increase in the MELD era. Pre-defined risk factors accurately predicted the risk of infections in these patients.