Infectious complications after a liver transplant

Abstract

Liver transplantation is a life-extending procedure for patients with end-stage liver disease (ESLD), post-transplant infections continue to be a leading cause of morbidity and mortality. Infection risk varies over time, with issues most commonly related to transplant surgery and nosocomial infections in the early post-transplant period. Because of the increased burden of immunosuppression, opportunistic infections become more common between 1 and 12 months post-transplant. As immunosuppression is reduced after 12 months, the risk of opportunistic infections decreases. Recipients are still vulnerable to community-acquired infections, and recurrent cholangitis may become an issue in those with chronic allograft dysfunction or recurrent cholestatic liver disease. This article will go over a strategy for dealing with infectious complications in the early, intermediate, and late stages following liver transplantation, with a focus on the most common infections as well as those of emerging concern.