Early complications in adult liver transplant recipients at the Wits Donald Gordon Medical Centre, South Africa

Background Deceased donor liver transplantation (DDLT) is the transplant modality performed routinely in adults at Wits Donald Gordon Medical Centre (WDGMC). Infection, graft dysfunction, surgical and medical complications are common in the early post-transplant period, accounting for early morbidity and mortality. Objectives To provide a descriptive analysis of all complications in the first 30 days post DDLT. To investigate associations between recipient demographic data, comorbid diabetes, MELD score, and subsequent complications. Methods A retrospective review of adult DDLT recipients for the first 30 days post-transplant performed at WDGMC for the period January 2015 - December 2016. Fischer’s exact test was used to assess relationships between demographic data and infectious complications, whilst an independent sample t-test was used for non-infectious complications. Results Seventy-eight DDLT were performed, with 6 (8%) mortalities in the first 30 days. The median age was 54 years; 54% were male. In total, 24 recipients (31%) developed infectious complications. Sixteen patients (67% of the infectious cohort) had intra-abdominal sepsis, 6 (25%) developed lower respiratory tract infections, 6 (25%) skin and soft tissue infections, and 3 (13%) urinary tract infections. Of all infectious complications, 7 patients (29%) developed bacteremia. Non-infectious complications developed in 55 patients (71%) of which renal complications were more common (67%). No significant association between age, gender, ascites, diabetes mellitus, MELD score, and any complications was found. Conclusion Non-infectious complications were more prominent than infectious complications in the first 30 days post-DDLT in adult recipients, with no significant association between recipient demographic data, comorbid diabetes, CMV status, and MELD score. Keywords: Early complications, liver transplant recipients, Deceased donor liver transplantation, Wits Donald Gordon Medical Centre, Model for End-Stage Liver Disease