Prevention and treatment of pulmonary infection following liver transplantation

BACKGROUND: Subsequent to liver transplantation, pulmonary infection and new drug resistant strain frequently appear due to complex pathophysiological changes and abuse of antibiotics.OBJECTIVE: To collect the clinical data of 6 cases who underwent liver transplantation, and analyze the prevention and treatment measures of pulmonary infection after liver transplantation.DESIGN, TIME AND SETTING: Retrospective case analysis, performed in the Department of Hepatobiliary Surgery,First People's Hospital of Guangzhou between January and December 2004.PARTICIPANTS: Six cases that underwent liver transplantation and received treatment in the First People's Hospital of Guangzhou were recruited in the present study. All 6 cases underwent selective homologous whole liver transplantation, 5cases underwent modified orthotopic piggyback liver transplantation, and only 1 underwent classical orthotopic liver transplantation.METHODS: The clinical data of the 6 cases were retrospectively analyzed. After transplantation, basic disinfection,isolation, infection-protection measures should be taken. In addition, etiological information was collected. Chest X-ray was underwent to know the lung at the early stage. Aseptic manipulating was strictly performed during sputum aspiration.Gastrointestinal decompression and non-obstructed drainage were maintained to prevent aspiration. Moreover, preventive anti-infective treatment against the bacteria, fungi, and viruses was performed.MAIN OUTCOME MEASURES: Pulmonary infection and curative effects subsequent to liver transplantation.RESULTS: Of the 6 cases, 5 presented with pulmonary infection, including 1 at 4-11 days after transplantation and 1 at 1day after transplantation. One case died of respiratory failure. The remaining 5 cases were cured after standardized anti-infection, respiratory therapy, sputum aspiration, and nutritional support.CONCLUSION: Application of effective antibiotics, aseptic operation in sputum aspiration, and unobstructed respiratory tract drainage are important measures for treating pulmonary infection subsequent to liver transplantation.