Infections in recipients of liver homografts.

Seventeen patients received liver homografts between 1963 and May, 1968. The eight treated before July, 1967, died within 34 days; seven had progressive infections with gram-negative bacilli. Candida albicans and cytomegalovirus. The infections were similar to but more fulminating than those after renal homotransplantation. In nine later cases. there was more discriminating donor selection. improved immunosuppression. and better organ preservation. In the first five of these nine patients. all infants, lobar hepatic gangrene I \:FECTIO\: i~ the most serious undesirahle side effect of the immunosuppressive therapy that is Ile<:essary in clinical organ transplantation. This was well do<:umented hy RHkind et al.. 1 who showed that 2(i of the first :30 recipients of renal homografts at the l'niversity of Colorado \Iedi<:al Center had infectious <:omplicatiolls. In a later analysis. Hill et aP reported that infectioH had <:aused or contrihuted to more than two thirds of all the deaths that had o<:<:urred lip to 19()(i in our transplantation patients. The present report presents information on the infectious <:ompli<:ations seen in a series of liver transplantations .. -\ numher of hacterial. viral. fungal ami protozoan diseases similar to those en<:ountered after renal homotransplantation were seen. In addition. a more specifi<: <:omplication of hepati<: homograft infection will he des<:rihed that <:01npli<:ated the course or <:aused the death of the first five <:onse<:utive patients who survived for two months or more.