Liver transplantation in man. The significance, patterns, and control of infection

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Abstract
Of 9 patients who survived the immediate postoperative period after hepatic transplantation, 6 later died from infection. Pulmonary infection was the major problem. Biliary infection related to bile fistulas may be less in the future with the improved technique of a cholecystdochostomy which was carried out in the last 2 patients. Frequent bacteriaemias were noted and the organisms were often the same as those found in the bile. Most infections were thought to be autogenous. Cytomegalovirus infection occurred in 6 patients, but in none was there evidence that the virus did harm. Broad-spectrum antibiotic therapy was freely used in the earlier patients but was often followed by superinfection with resistant organisms and fungi. The present policy is not only to use antibiotics sparingly but to rely on narrow-spectrum drugs wherever possible.