Routine Bile Culture From Liver Donors as Screening of Donor-Transmitted Infections in Liver Transplantation.

2020 
Bacterial infections are an important threat in the early post-liver transplantation period. Donor-transmitted infections, although rare, can have high mortality. The utility of routine culture from the donor bile duct as screening of donor-transmitted infection has not been evaluated. We performed a retrospective study of 200 consecutive liver transplants between 2010 and 2015. Demographic, clinical, and microbiological data were collected from the recipients' medical records. Clinical data included pretransplantation, perioperative, and posttransplantation information (until 30 days after the procedure). Three-month patient survival and/or retransplantation were recorded. A total of 157 samples from the donor bile duct were collected and cultured. Only 8 were positive. The microorganisms isolated were as follows: 2 Klebsiella pneumoniae, 1 Escherichia coli, 1 Enterobacter cloacae, 1 Streptococcus anginosus, 1 Streptococcus sp, 1 multiple gram-negative bacilli, and 1 polymicrobial. All the microorganisms were susceptible to the antibiotic prophylaxis administered. During the first month after transplantation, 81 recipients developed 131 infections. Only 1 of these recipients had a donor with positive bile culture, and none of the infections were due to the microorganism isolated in the donor's bile. Three-month overall survival was 89.5%, and there were no differences between recipients with positive donor bile culture and those with negative donor bile culture (87.5% vs. 89.26%; P > 0.99). CONCLUSION: Routine testing of donor bile culture does not predict recipients' infection or survival after liver transplantation and should not be recommended.
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