P-115 MANAGEMENT AND OUTCOME OF LIVER ABCESS AFTER LIVER TRANSPLANTATION: EXPERIENCE OF A SINGLE CENTER IN PERU

• Main Authors: Augudberto Montufar, Carlos Rondón, Bacilio Wilmer, Omar Mantilla, José Rivera, Alfonso Solar, Bertha Cárdenas, Carmen Cerrón, Saul Espinoza, Martin Padilla
• Format: Article
• Language: English
• Published: Elsevier 2021-09-01
• Series: Annals of Hepatology
• Online Access: http://www.sciencedirect.com/science/article/pii/S1665268121001745

Introduction: Liver abscesses are a rare and serious complication in liver transplantation associated with hepatic artery thrombosis, biliary stenosis, choledocho-jejunostomy, cholangitis, living donor liver transplantation, Split liver, DCD, liver biopsy and diabetes. Objectives: To show the experience in the diagnosis, treatment, and results of liver abscesses in liver transplant patients in 20 years in the Transplant Department of the Guillermo Almenara National Hospital. EsSalud. Methods: Descriptive, cross-sectional, retrospective study. We reviewed the demographic data and the clinical characteristics, type of graft, donor, time of transplantation, size, and number of lesions, as well as isolated germs, use of antimicrobials, treatment, and mortality. Results: Twelve patients were identified in 303 liver transplants (3.96%). The average age was 57 years. Symptoms: fever, pain, general malaise. Abnormal liver function test: 50% and 90% had elevated GGTP. Acute kidney injury in 6 cases (50%). Hospital staying: 32 days (4-135). Liver abscess developed at 63 months on average. Size 8 cm (2-23 cm). One lesion: 9 (75%); the most compromised liver segment was VI and VIII: Choledocho-jejunostomy: 83%. Biliary strictures (5 cases 41.6%): 2 related to hepatic artery thrombosis, 2 hepatic artery stenosis, and one case related to TACE. Treatment: Cultures: E. Coli and candida. Antibiotics:: Carbapenem and vancomycin. Surgical drainage (1, 8.3%) and percutaneous drains (11, 91.6%) were performed. Mortality was 8.3% (1 case: related to the abscess) Conclusions: The results of our experience show a similar prevalence to other studies, we found no relationship with the indication for transplantation, 80% of the cases occurred in the first 100 days, the main risk factors were biliodigestive diversion, vascular and biliary complications; Most of the treatment was by percutaneous drainage and antibiotic treatment lasted 4 to 6 weeks.