To investigate the microbial cultivation of pathogens in organ preservation solution and its impact on the postoperative infection of liver transplant recipients.

Clinical data of 273 recipients undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from October 2017 to December 2018 were retrospectively analyzed. The informed consents of all recipients and (or) families were obtained and the local ethical committee approval was received. Among them, 238 patients were male and 35 female, aged from 16 to 77 years, with a median age of 49 years. Bacterial, fungal detection and drug sensitivity analysis were performed for the organ preservation solution and blood, urine, sputum, ascites of recipients after liver transplantation. The transmission of organ-derived pathogens and the infection of transplant recipients were analyzed.

The positive rate of pathogen culture in organ preservation solution was 45.8%(125/273). The common bacteria mainly consisted of Staphylococcus epidermidis (n=20), Staphylococcus aureus (n=12), Enterococcus faecalis (n=11), Acinetobacter baumannii (n=11) and Klebsiella pneumoniae (n=10). Acinetobacter baumannii and Klebsiella pneumoniae were resistant to different antibiotics. The resistance rate of Acinetobacter baumannii to carbapenems was 91%, and 30% for Klebsiella pneumoniae to carbapenems. After liver transplantation, potential organ-derived pathogen transmission was observed in 9 recipients, including 5 cases of Acinetobacter baumannii, 2 cases of Enterococcus faecalis, 2 cases of Staphylococcus epidermidis and 1 case of Klebsiella pneumoniae. 2 recipients presented with potential organ-derived pathogen infection, which were pan-drug resistant Acinetobacter baumannii and Klebsiella pneumoniae. The common sites of positive organ-derived pathogens were abdominal cavity, followed by lung, blood and abdominal wounds.

The pathogens in organ preservation solution are complex and diverse, most of which are derived from skin or intestinal flora. Multi-drug-resistant bacteria are likely to lead to infection of recipients and adverse events. Abdominal cavity is the part with highest detection rate of organ-derived pathogens.