Infected bilomas in liver transplant recipients: clinical features, optimal management, and risk factors for mortality

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Nasia SafdarDennis G Maki

Abstract

Infected hepatic fluid collections (bilomas) are a major infectious complication of liver transplantation. Limited data exist on management and outcome of biloma. We report a cohort study of 57 liver transplant recipients with posttransplantation bilomas undertaken to identify the clinical features of biloma, management strategies, and outcome. Fever (44%) and abdominal pain (40%) were the most common presenting symptoms, but one-third of patients were asymptomatic; 79% had elevated hepatic enzyme levels. Patients without hepatic artery thrombosis (HAT) had the highest rates of resolution with percutaneous drainage and anti-infective therapy (64%). Retransplantation was necessary in 64% of patients with HAT and biloma. Independent predictors of resolution with nonsurgical therapy were absence of HAT (odds ratio [OR] 7.69; P=.01) and absence of Candida (OR, 9.09; P=.02) or enterococcal infection (OR, 7.69; P=.03). Patients with bilomas had significantly greater mortality (Cox proportional hazard ratio [HR], 2.38; P=.008, by log rank test) and graft loss (HR, 4.31; P<.0001). Predictors of mortality by multivariable analysis included renal insufficiency (OR, 12.51; P=.02) or infection with Candida species (OR, 4.93; P=.03) or gram...Continue Reading

References

Aug 1, 1988·British Journal of Industrial Medicine·H Une, H Esaki
Apr 1, 1983·AJR. American Journal of Roentgenology·P R MuellerE vanSonnenberg
Jan 1, 1982·American Journal of Epidemiology·S Lemeshow, D W Hosmer
Oct 1, 1994·Clinical Microbiology Reviews·B D JettM S Gilmore
Oct 1, 1996·European Journal of Gastroenterology & Hepatology·B MacfarlaneA K Burroughs
May 26, 1998·American Journal of Surgery·J M RabkinA J Olyaei
Jul 17, 1998·Transplant International : Official Journal of the European Society for Organ Transplantation·C MargaritJ Balsells
Oct 3, 2000·Surgery·A M D'alessandroM Kalayoglu
Dec 1, 2001·Trends in Microbiology·K Haynes
May 1, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Satheesh NairPaul J Thuluvath
Jan 25, 2003·Transplantation·Olympia A TachopoulouThomas F Keys
Jun 5, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Fulya GunsarAndrew K Burroughs
Jun 5, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Barbara J StangePeter Neuhaus

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Citations

May 24, 2011·World Journal of Hepatology·Fabian A Romero, Raymund R Razonable
May 10, 2012·Future Microbiology·Shmuel Shoham, Kieren A Marr
Jul 18, 2006·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Teresa BerrocalManuel López Santamaría
Nov 26, 2015·Journal of Hepatology·UNKNOWN European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu
Jul 4, 2007·Clinics in Liver Disease·Shirish Huprikar
Sep 25, 2008·Transplant Infectious Disease : an Official Journal of the Transplantation Society·M HashimotoM Makuuchi
Jan 3, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michael R LuceyLewis W Teperman
Apr 21, 2011·Transplant Infectious Disease : an Official Journal of the Transplantation Society·N P HarlanD T Kuhar
Apr 21, 2016·The Medical Clinics of North America·William G Greendyke, Marcus R Pereira
Jun 21, 2005·Transplantation Proceedings·B NemesL Kóbori
May 28, 2014·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·C CerveraUNKNOWN ESCMID Study Group for Infections in Compromised Hosts
Jan 16, 2015·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Juan C CamachoPardeep K Mittal
Jul 14, 2016·Clinical Transplantation·Oskar KornasiewiczMarek Krawczyk
Apr 23, 2014·Current Opinion in Organ Transplantation·Christian van Delden
Apr 19, 2008·Pediatric Blood & Cancer·Jeffrey LebensburgerWinfred Wang
Sep 6, 2017·Clinical Transplantation·Manuela CesarettiAlban Zarzavadjian Le Bian
Jun 10, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Emmanuel LafontAgnès Lefort
May 19, 2019·Clinical Transplantation·Ghady HaidarUNKNOWN American Society of Transplantation Infectious Diseases Community of Practice
Sep 29, 2017·Clinical Liver Disease·Kim Daniel, Adnan Said
Apr 6, 2019·BMC Gastroenterology·S WürstleJ Schneider
Oct 12, 2016·Microbiology Spectrum·Lesia K Dropulic, Howard M Lederman

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