Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay:A single-center retrospective observational study in China

Background:Normal bile is sterile.Studies have shown that cholangitis after liver transplantation(LT)was associated with a relatively poor prognosis.It remains unclear whether the bacteriobilia or fungibilia impact the patient outcomes in LT recipients,especially with donation after circulatory death(DCD)allografts,which was correlated with a higher risk of allograft failure.Methods:This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021.All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia.The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes,especially hospital stay were analyzed.Results:Totally 135 and 171 organisms were isolated at weeks 1 and 2,respectively.Among all patients included in this analysis,83(59.7%)developed bacteriobilia or fungibilia within 2 weeks posttransplantation.The occurrence of bacteriobilia or fungibilia[β=7.43,95%CI(confidence interval):0.02 to 14.82,P=0.049],particularly the detection of Pseudomonas(β=18.84,95%CI:6.51 to 31.07,P=0.003)within 2 weeks post-transplantation was associated with a longer hospital stay.However,it did not affect the graft and patient survival.Conclusions:The occurrence of bacteriobilia or fungibilia,particularly Pseudomonas within 2 weeks posttransplantation,could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.