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Peer-reviewedCC BY-NC 4.0Iranian Journal of Microbiology

Surgical site infection in liver transplant recipients: risk factors and microbial agents from a high volume liver transplant center in Iran

  • Fereshteh Ghiasvand1
  • Zahra Jahani2,3
  • Ali Jafarian4
  • Elham Madreseh5
  • Zahra Ahmadinejad1
5 affiliations
  1. 1Department of Infectious Diseases, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2Department of Infectious Diseases, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4Department of Liver Transplant and Hepatobiliary Surgery, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  5. 5Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract

Background and Objectives:: Surgical site infection (SSI) is an important complication among liver transplant (LT) recipients. This study aimed to determine the prevalence, risk factors and microbial etiologies of SSI in LT recipients.

Materials and Methods:: This retrospective observational study was conducted at a tertiary care hospital, Imam Khomeini Hospital complex, Tehran, Iran, between 2015 and 2020. Clinical data were collected from password-protected database.

Results:: A total of 200 patients were included, of whom 121 (60.5%) were men. The mean age was 43.85 ± 14.59 years. Ninety-six patients (48%) developed SSI. broad-spectrum antibiotics use (p=.005), preoperative corticosteroids and immunosuppressive therapy (P = .000), Prolonged ICU stay (P=.000), and higher MELD score before transplantation (P = .002) were significantly associated with SSI. Graft rejection and one-year mortality rates were higher among patients with SSI; however, these differences were not statistically significant. SSI was also more common among patient with diabetes mellitus, other non-hepatic comorbidities, moderate-to-severe ascites, and those receiving piperacillin-tazobactam prophylaxis after surgery. The most frequently isolated microorganisms from SSI culture were Klebsiella pneumoniae (25%), Enterococcus spp. (22.9%) and Escherichia coli (16.6%).

Conclusion:: SSI remains a common complication among LT in our canter and should be suspected in patients presenting with infection during the first postoperative month. Recipients with advanced liver disease, prolonged ICU stay, preoperative immunosuppressive therapy, and post-transplant hemodialysis may require monitoring.

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Cite

BibTeXRIS
BibTeX
@article{ghiasvand2026surgical,
  title = {{Surgical site infection in liver transplant recipients: risk factors and microbial agents from a high volume liver transplant center in Iran}},
  author = {Fereshteh Ghiasvand and Zahra Jahani and Ali Jafarian and Elham Madreseh and Zahra Ahmadinejad},
  journal = {Iranian Journal of Microbiology},
  year = {2026},
  month = nov,
  doi = {10.18502/ijm.v18i5.22857},
  url = {https://doi.org/10.18502/ijm.v18i5.22857},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Surgical site infection in liver transplant recipients: risk factors and microbial agents from a high volume liver transplant center in Iran
AU  - Fereshteh Ghiasvand
AU  - Zahra Jahani
AU  - Ali Jafarian
AU  - Elham Madreseh
AU  - Zahra Ahmadinejad
PY  - 2026
DA  - 2026/11/06
JO  - Iranian Journal of Microbiology
DO  - 10.18502/ijm.v18i5.22857
UR  - https://doi.org/10.18502/ijm.v18i5.22857
AB  - Background and Objectives:: Surgical site infection (SSI) is an important complication among liver transplant (LT) recipients. This study aimed to determine the prevalence, risk factors and microbial etiologies of SSI in LT recipients.  Materials and Methods:: This retrospective observational study was conducted at a tertiary care hospital, Imam Khomeini Hospital complex, Tehran, Iran, between 2015 and 2020. Clinical data were collected from password-protected database.  Results:: A total of 200 patients were included, of whom 121 (60.5%) were men. The mean age was 43.85 ± 14.59 years. Ninety-six patients (48%) developed SSI. broad-spectrum antibiotics use (p=.005), preoperative corticosteroids and immunosuppressive therapy (P = .000), Prolonged ICU stay (P=.000), and higher MELD score before transplantation (P = .002) were significantly associated with SSI. Graft rejection and one-year mortality rates were higher among patients with SSI; however, these differences were not statistically significant. SSI was also more common among patient with diabetes mellitus, other non-hepatic comorbidities, moderate-to-severe ascites, and those receiving piperacillin-tazobactam prophylaxis after surgery. The most frequently isolated microorganisms from SSI culture were Klebsiella pneumoniae (25%), Enterococcus spp. (22.9%) and Escherichia coli (16.6%).  Conclusion:: SSI remains a common complication among LT in our canter and should be suspected in patients presenting with infection during the first postoperative month. Recipients with advanced liver disease, prolonged ICU stay, preoperative immunosuppressive therapy, and post-transplant hemodialysis may require monitoring.
SN  - 2008-3289
SN  - 2008-4447
ER  -