Transplant infectious disease : an official journal of the Transplantation Society · 2026
Clinical Significance of Organ Preservation Fluid Cultures in Pediatric Abdominal Solid Organ Transplantation.
СтатьяНазвание и аннотация: Перевод в очереди
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Jamal Hassan A, Kwon Yong K, Valentino Pamela L, Smith Jodi M, Healey Patrick J, Teoh Zheyi
Аннотация
BACKGROUND: Pediatric data on preservation fluid cultures (PFCs) and their ability to predict preservation fluid-related posttransplant infections (PF-I) remain uncertain. In addition, clinical guidelines do not provide uniform recommendations regarding when to obtain PFC or how to manage positive results, particularly for children. In this study, we aimed to evaluate PFC-positive status and PF-I in pediatric abdominal solid organ transplant (aSOT) recipients.
METHODS: We conducted a retrospective, single pediatric center study of aSOT-recipients between 2012 and 2024, where PFCs were obtained routinely. Data were collected via chart review and included prespecified outcomes such as posttransplant bacterial infections, allograft rejection, unexpected return to the operating room, prolonged hospitalization, and death within 30 days posttransplant. PF-I was defined as a culture-concordant infection in the setting of PFC-positive status.
RESULTS: Among 337 aSOT recipients, PFCs were positive in 49 patients (14.5%). Coagulase-negative Staphylococci and Cutibacterium spp. were the most isolated organisms (63%). Infectious complications were more frequent in patients with PFC-positive status (30.6% vs. 18.4%; p = 0.049). Two PF-I episodes (4.1% of PFC-positive status) were identified, both in infant liver transplant recipients, involving vancomycin-resistant Enterococcous and methicillin-sensitive Staphylococcus aureus. At 30 days after transplantation, a higher percentage of the PFC-positive group remained hospitalized (18.4% vs. 8.7%; p = 0.037), whereas of the proportion of rejection, reoperation, and mortality was similar.
CONCLUSIONS: PFC-positive status and PF-I were uncommon in this cohort. The utility of routine bacterial PFC is primarily to identify the growth of organisms considered pathogenic and to guide preemptive antibiotic therapy.
METHODS: We conducted a retrospective, single pediatric center study of aSOT-recipients between 2012 and 2024, where PFCs were obtained routinely. Data were collected via chart review and included prespecified outcomes such as posttransplant bacterial infections, allograft rejection, unexpected return to the operating room, prolonged hospitalization, and death within 30 days posttransplant. PF-I was defined as a culture-concordant infection in the setting of PFC-positive status.
RESULTS: Among 337 aSOT recipients, PFCs were positive in 49 patients (14.5%). Coagulase-negative Staphylococci and Cutibacterium spp. were the most isolated organisms (63%). Infectious complications were more frequent in patients with PFC-positive status (30.6% vs. 18.4%; p = 0.049). Two PF-I episodes (4.1% of PFC-positive status) were identified, both in infant liver transplant recipients, involving vancomycin-resistant Enterococcous and methicillin-sensitive Staphylococcus aureus. At 30 days after transplantation, a higher percentage of the PFC-positive group remained hospitalized (18.4% vs. 8.7%; p = 0.037), whereas of the proportion of rejection, reoperation, and mortality was similar.
CONCLUSIONS: PFC-positive status and PF-I were uncommon in this cohort. The utility of routine bacterial PFC is primarily to identify the growth of organisms considered pathogenic and to guide preemptive antibiotic therapy.