NGHIÊN CỨU TÌNH TRẠNG NHIỄM TRÙNG SAU GHÉP GAN

Abstract

Liver transplantation is the definitive treatment for patients with chronic liver disease in developed countries and is increasingly advancing in Vietnam. The high survival rates of liver transplant recipients are largely attributed to the availability of potent immunosuppressive therapies. However, systemic immunosuppression renders these patients more susceptible to new infections, as well as the reactivation of latent ones. Infections occurring within the first month post-transplant are often hospital-acquired, donor-derived, or associated with perioperative complications. This study aims to investigate the clinical and subclinical characteristics of post-transplant infections and identify potential associated factor. Subjects and Methods: This is a descriptive cross-sectional study, combining both retrospective and prospective data, conducted on 205 liver transplant recipients at the 108 Military Central Hospital from 2024 to June 2025. Infection criteria were based on the 2013 EASL guidelines: patients presenting with postoperative fever ≥38°C and/or CRP ≥1 mg/dL and/or procalcitonin ≥0.5 ng/mL were considered to have an infection. Specific diagnoses of common infections (e.g., pneumonia, urinary tract infection, intra-abdominal infection, sepsis) were made according to standards set by the Ministry of Health and international guidelines. The analyzed factors included age, gender, MELD score, Child-Pugh score, clinical and laboratory features, and infection-related mortality. Data were collected from patient medical records and analyzed using SPSS version 20.0. Results: Mean age: approximately 57.6 ± 11.4 years. Male patients: approximately 85.4%. Acute-on-chronic liver failure (ACLF) (35%), hepatocellular carcinoma (HCC) (30%), and  cirrhosis (25%). The post-transplant infection rate was 94.6%. Pneumonia (38%) and other infections (54%) were the most common types. Infection-related mortality accounted for 7.7%. No statistically significant associations were found between infection and gender, age, MELD score, or Child-Pugh score (p > 0.05). Conclusion: Infection is a common and significant complication following liver transplantation, with pneumonia and sepsis being the most prevalent types. Traditional risk factors such as age, gender, MELD, and Child-Pugh scores were not significant predictors of infection, underscoring the importance of close postoperative monitoring and prompt implementation of infection control measures.