MICROBIOLOGICAL MONITORING OF PATIENTS IN HEPATIC FAILURE WITH PARTICULAR REFERENCE TO EXTRACORPOREAL PORCINE LIVER PERFUSION

Abstract Bacteriological screening to detect colonisation with potential pathogens was performed on 19 patients, admitted in hepatic failure, who were being considered for treatment with pig-liver perfusion. 6 patients who did not receive antibiotic therapy retained their normal gram-positive skin flora. 5 patients showed skin colonisation with gram-negative organisms while receiving antibiotic therapy. It is suggested that antibiotics should be withheld from such patients until clear evidence of infection is obtained. Bacteraemia was demonstrated in 7 patients, although there was little clinical evidence. Frequent monitoring may be necessary to demonstrate the persistence of an organism in the bloodstream. The use of the inguinal area for intravenous catheterisation should be avoided, since potential pathogens were isolated from the inguinal region in 85% of these patients. It is suggested that in one patient the organisms isolated from the post-perfusion specimens may have originated in the porcine circulation.