Postoperative Infections and Antimicrobial Prophylaxis After Pediatric Liver Transplantation

Research conducted at 12 liver transplant centers in the United States over two years examined the incidence and risk factors for postoperative infections after pediatric liver transplantation. The study found that 23% of patients (76 out of 327) developed postoperative infections, with bacterial, viral, fungal, and polymicrobial infections accounting for 47%, 3%, 4%, and 22% of cases, respectively. Abdominal and surgical site infections were the most common, affecting 29% and 26% of patients, respectively. Independent predictors of postoperative infections included age under 1 year and open fascia.

Key Takeaways:

• The study identified a 23% incidence of postoperative infections among pediatric liver transplant recipients, with bacterial, viral, fungal, and polymicrobial infections affecting 47%, 3%, 4%, and 22% of patients, respectively.
• Abdominal and surgical site infections were the most common types of postoperative infections, affecting 29% and 26% of patients, respectively.
• Age under 1 year and open fascia were identified as independent predictors of postoperative infections.
• The study highlights the need for future prospective research to optimize antimicrobial regimens and improve outcomes for pediatric liver transplant recipients.
• The research emphasizes the importance of postoperative infection prevention and control measures in pediatric liver transplantation.

Statistics:

• 23% of pediatric liver transplant recipients developed postoperative infections.
• 76 out of 327 patients developed postoperative infections.
• 47% of postoperative infections were bacterial.
• 3% of postoperative infections were viral.
• 4% of postoperative infections were fungal.
• 22% of postoperative infections were polymicrobial.
• 29% of postoperative infections were abdominal/surgical site infections.
• 26% of postoperative infections were bloodstream infections.
• 2.37 (95% CI 1.36-4.13) was the odds ratio for age under 1 year as an independent predictor of postoperative infections.
• 3.15 (95% CI 1.77-5.61) was the odds ratio for open fascia as an independent predictor of postoperative infections.

Sources:

• "Postoperative Infections and Antimicrobial Prophylaxis In the Pediatric Intensive Care Unit After Liver Transplantation In Children." Pediatric Transplantation, 2025;29(6).
• "Investigators at Columbia University Describe Findings in Liver Transpls (Postoperative Infections and Antimicrobial Prophylaxis In the Pediatric Intensive Care Unit After Liver Transplantation In Children)." Pediatrics Week. November 1, 2025; p 596.