Early complications in adult liver transplant recipients at the Wits Donald Gordon Medical Centre, South Africa

Chiba, Sheetal; Lowman, Warren; Schleicher, Gunter

doi:10.52378/hmer7639

Early complications in adult liver transplant recipients at the Wits Donald Gordon Medical Centre, South Africa

Document Type : Original Clinical

Authors

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.

10.52378/hmer7639

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.

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