Graft Hepatic Artery Rupture Due to Carbapenem-Resistant Klebsiella pneumoniae Infection After Liver Transplant

Exp Clin Transplant. 2020 Aug;18(4):529-532. doi: 10.6002/ect.2018.0384. Epub 2019 Aug 19.

Abstract

Carbapenem-resistant Klebsiella pneumoniae infection is a major cause of morbidity and mortality after solid-organ transplant and hematopoietic stem cell transplant. Here, we report a 57-year-old man with hepatitis B virus-related decompensated liver cirrhosis, huge splenic artery aneurysm, and hypersplenism who underwent liver transplant from a deceased brain-dead donor. Recipient sputum surveillance showed carbapenem-resistant Klebsiella pneumoniae when he entered the intensive care unit, and combined tigecycline, meropenem, and fosfomycin were administered. At 1 week posttransplant, the recipient's hepatic artery was eroded by disseminated carbapenem-resistant Klebsiella pneumoniae infection, and the patient developed acute kidney injury. Our experience suggests that colonization of carbapenem-producing organisms may be included during surveillance posttransplant and that the infected graft artery must be removed instead of noninfected vessels.

Publication types

  • Case Reports

MeSH terms

  • Carbapenems / therapeutic use*
  • Drug Resistance, Bacterial*
  • Fatal Outcome
  • Hepatic Artery / microbiology*
  • Hepatic Artery / transplantation*
  • Hepatitis B / complications*
  • Hepatitis B / diagnosis
  • Hepatitis B / virology
  • Humans
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / therapy
  • Klebsiella pneumoniae / pathogenicity*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / surgery*
  • Liver Cirrhosis / virology
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Risk Factors
  • Rupture, Spontaneous
  • Treatment Outcome

Substances

  • Carbapenems