Infections in Liver Retransplantation: A Prospective Study of Microbial Patterns, Immune Biomarkers, and Survival

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dc.contributor.authorKarakaş, Ezgi Erdal
dc.contributor.authorToplu, Sibel Altunışık
dc.contributor.authorŞahin, Tevfik Tolga
dc.contributor.authorKarakaş, Serdar
dc.contributor.authorSatılmış, Basri
dc.contributor.authorAkbulut, Sami
dc.contributor.authorBayındır, Yaşar
dc.date.accessioned2026-04-04T13:18:56Z
dc.date.available2026-04-04T13:18:56Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractBackground: Liver retransplantation (Re-Tx) recipients are at elevated risk for infectious complications due to increased immunologic and clinical vulnerability. However, prospective data on infection incidence, microbial etiology, immune biomarkers, and survival outcomes in this population remain limited. Methods: We conducted a prospective cohort study of 26 adult Re-Tx recipients treated between 2021 and 2023 at the Inonu University Liver Transplantation Institute (Malatya, Türkiye). Demographic, clinical, and laboratory data—including preoperative immune biomarkers (TNF-α, TGF-β, IL-1β, IL-4, IL-6, IL-22, β-galactosidase, GDH, IFN-γ, GM-CSF)—were collected. Infections were classified as early (0–30 days) or early-intermediate (1–6 months) post-transplant. Multivariate logistic regression was used to assess infection risk factors. Kaplan–Meier analysis was performed to evaluate survival. Results: Female sex (OR = 7.377) and elevated procalcitonin levels on postoperative day 3 (OR = 1.054) were independently associated with early infections. Early infections were predominantly caused by gram-negative bacteria and fungi, including E. coli, Klebsiella spp., and Acinetobacter baumannii. These infections significantly reduced 1-, 3-, and 5-year survival rates (log-rank P < .05). No significant differences were found in preoperative immune biomarker levels between infected and non-infected patients (P > .05). Conclusions: Re-Tx recipients face high early infection risk, especially from multidrug-resistant organisms such as Candida spp. and A. baumannii. Female sex and postoperative PCT elevation may serve as early warning indicators. Although biologically relevant, preoperative immune biomarkers showed limited prognostic value. Tailored prophylactic and monitoring strategies are needed in this high-risk group. © 2026 Elsevier Inc.
dc.description.sponsorshipInonu University Scientific Research Projects Unit; Inönü Üniversitesi, (TTU-2022-2920); Inonu University, (2022/09)
dc.identifier.doi10.1016/j.transproceed.2026.02.004
dc.identifier.issn0041-1345
dc.identifier.pmid41763944
dc.identifier.scopus2-s2.0-105031839703
dc.identifier.scopusqualityQ3
dc.identifier.urihttps://doi.org/10.1016/j.transproceed.2026.02.004
dc.identifier.urihttps://hdl.handle.net/11616/108021
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Inc.
dc.relation.ispartofTransplantation Proceedings
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_Scopus_20250329
dc.titleInfections in Liver Retransplantation: A Prospective Study of Microbial Patterns, Immune Biomarkers, and Survival
dc.typeArticle

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