Postoperative infectious complications in paediatric liver transplantation: a study of 48 transplants

We studied, retrospectively, postoperative infectious complications following paediatric liver transplantation at a single university centre. The objectives were to characterize the epidemiology of infection and to determine the associated risk factors during the early postoperative period, either the first postoperative month or the entire duration of paediatric intensive care unit (PICU) stay. Forty-eight liver transplants were performed on 46 patients. Sixty-three infections occurred in 32 patients who underwent 34 liver transplantations (1.36 infection/ patient); 47 were bacterial, 6 fungal and 10 viral. The most common sites of infection were bloodstream (36.5%) and abdomen (30%). Gram-positive bacteria (78%) predominated over gram-negative bacteria (22%). Initial analysis revealed infection risk factors to be age < 1 year, body weight < 10 kg, extrahepatic biliary atresia, intraoperative transfusion > 160 ml.kg(-1), mechanical ventilation > 8 days and PICU stay > 19 days. After stratified analysis, the main risk factor for infection was low body weight of the recipient.