{
  "abstract": "Objectives\n\nInfectious complications, particularly those caused by multidrug-resistant organisms (MDROs), remain a major cause of morbidity and mortality after liver transplantation (LT). While pre-transplant colonization is a recognized risk factor, its prognostic significance relative to post-transplant MDRO status remains unclear. This study evaluated the clinical impact of MDRO presence across the transplant timeline and identified predictors of post-transplant mortality and graft dysfunction.Methods\n\nA retrospective cohort study of 110 adult LT recipients (2018-2024) was conducted at a tertiary center. Patients were stratified by pre-transplant ESBL/MDRO colonization or infection and by post-transplant MDRO status (modeled as a time-dependent exposure). Primary outcomes were one-year all-cause mortality and adverse graft outcomes.Results\n\nPre-transplant ESBL/MDRO presence (40% of recipients) was not associated with increased one-year mortality or adverse graft outcomes. Conversely, post-transplant MDRO status occurred in 44.5% of patients and was strongly associated with poor outcomes. Post-transplant MDRO colonization or infection was present in 88% (14/16) of non-survivors vs. 37% (35/94) of survivors (p < 0.001). One-year mortality was 47% (9/19) for post-transplant MDRO infection, 17% (5/30) for colonization alone, and 3% (2/61) with no post-transplant MDRO event. In a penalized time-dependent Cox model, post-transplant MDRO acquisition was independently associated with one-year mortality (HR 4.0, 95% CI 1.77-9.03; p < 0.001), confirmed by landmark analysis (HR 3.15, 95% CI 1.08-9.19), whereas pre-transplant status showed no association (p = 0.18).Conclusions\n\nWhile pre-transplant status did not significantly impact one-year mortality in this cohort, post-transplant MDRO acquisition was independently associated with one-year mortality. Pre-transplant status should guide targeted prophylaxis, whereas the post-transplant period represents the critical window for infection prevention and antimicrobial stewardship interventions.",
  "abstract_shown": true,
  "affiliations": [
    "Institute for Research in Military Medicine, Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.",
    "The Israel Defense Forces Medical Corps, Jerusalem 5262000, Israel.",
    "Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem 91120, Israel.",
    "Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.",
    "Department of Medical Intensive Care, Hadassah Medical Center, Jerusalem 91120, Israel.",
    "Transplantation Unit, Hadassah Medical Center, Jerusalem 91120, Israel.",
    "Clalit Health Services, Jerusalem District, P.O. Box 27670, Jerusalem 9127601, Israel."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Emil Aliev",
      "orcid": "0009-0008-0506-9644"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Efrat Orenbuch-Harroch"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Abed Khalaileh",
      "orcid": "0000-0002-4878-8189"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Ashraf Imam",
      "orcid": "0000-0003-0172-3844"
    },
    {
      "affs": [
        3,
        6
      ],
      "name": "Matan Joel Cohen"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Maya Korem",
      "orcid": "0000-0003-3276-0963"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bktsg1jgf7hsk.bib",
  "cited_by": 0,
  "doi": "10.3390/diseases14100362",
  "fulltext_url": "https://europepmc.org/articles/PMC13702940",
  "id": "bktsg1jgf7hsk",
  "issns": [
    "2079-9721"
  ],
  "landing_url": "https://europepmc.org/article/MED/42929989",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Organ Transplantation Techniques and Outcomes"
    ]
  ],
  "openalex": "W7215077342",
  "pdf_url": "https://europepmc.org/articles/PMC13702940?pdf=render",
  "pmcid": "PMC13702940",
  "pmid": "42929989",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bktsg1jgf7hsk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42929989",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42929989"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Organ Transplantation Techniques and Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "The Impact of Pre- Versus Post-Transplant Multidrug-Resistant Organism Colonization on Liver Transplant Outcomes: A Retrospective Cohort Study.",
  "title_text": "The Impact of Pre- Versus Post-Transplant Multidrug-Resistant Organism Colonization on Liver Transplant Outcomes: A Retrospective Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/bktsg1jgf7hsk",
  "venue": "Diseases (Basel, Switzerland)",
  "versions": []
}