Diagnosis and treatment of liver abscess after orthotopic liver transplantation

OBJECTIVE: To investigate etiology, diagnosis, treatment and prophylaxis of liver abscess after orthotopic liver transplantation (OLT). METHODS: Of 274 recipients of OLT from January 1993 to June 2003 in our transplant center, liver abscess were identified in 6 recipients (2.2%). The clinical presentation included fever, shiver, abdominal pain, jaundice, hepatic dysfunction, hypoalbuminemia, anemia, leukocytosis and neutrophilia. They were diagnosed mainly according to the clinical presentation and Ultrasonography or CT scan. The treatments included aspiration and drainage of abscess, removing bile sludge, antibiotics and supportive therapy. RESULTS: Of 6 patients, 2 were cured, 3 refused liver retransplantation and 2 died of serious systemic infection. The cure rate was 33.3%. CONCLUSIONS: the etiology of liver abscess after OLT is complicated. The predisposing factors might be included hepatic artery thrombosis or stenosis, MP pulse therapy, cholangitis and biliary interventional therapy. Its prognosis seemed disappointing. Strong prophylactic measures should be recommended to reduce the liver abscess after OLT.