Table 4.
Risk factors for IFI within 90 days of liver transplantation: univariate and multivariate Cox regression analyses (n = 224).
| Nondependent Variable | B-Coefficient | p-Value | HR | 95% CI | Multivariate Analysis | |||
|---|---|---|---|---|---|---|---|---|
| Lower | Upper | HR (95% CI) | p-Value | |||||
| Age (years) | −0.039 | 0.007 | 0.96 | 0.94 | 0.99 | 0.97 (0.94; 0.99) | 0.027 | |
| Sex (male) | 0.427 | 0.315 | 1.53 | 0.67 | 3.53 | |||
| Height (cm) | 0.015 | 0.523 | 1.02 | 0.97 | 1.06 | |||
| Weight (kg) | −0.006 | 0.626 | 0.99 | 0.97 | 1.02 | |||
| Body mass index (kg/m2) | −0.042 | 0.319 | 0.96 | 0.88 | 1.04 | |||
| SAPS III score | 0.015 | 0.556 | 1.02 | 0.97 | 1.07 | |||
| MELD score | 0.036 | 0.110 | 1.04 | 0.99 | 1.08 | |||
| Charlson comorbidity index | 0.046 | 0.580 | 1.05 | 0.89 | 1.23 | |||
| Underlying disease malignancy and other tumors (reference category) | ||||||||
| Alcoholic liver disease | 0.040 | 0.939 | 1.04 | 0.371 | 2.925 | |||
| Virus related | 0.041 | 0.969 | 1.04 | 0.132 | 8.224 | |||
| Non-alcoholic fatty liver disease | - | - | - | - | - | |||
| Budd-Chiari syndrome | - | - | - | - | - | |||
| Acute liver failure | 1.337 | 0.051 | 3.81 | 1.030 | 14.079 | |||
| Cholestatic | 0.593 | 0.374 | 1.81 | 0.490 | 6.683 | |||
| Autoimmune hepatitis | 0.961 | 0.219 | 2.61 | 0.565 | 12.104 | |||
| Metabolic Liver Disease | 0.137 | 0.897 | 1.15 | 0.145 | 9.051 | |||
| Other | 1.986 | 0.060 | 7.28 | 0.920 | 57.692 | |||
| Preoperative risk factors | ||||||||
| MELD Score > 30 | 0.767 | 0.158 | 2.15 | 0.74 | 6.25 | |||
| Fungal colonization at baseline | 1.293 | 0.009 | 3.65 | 1.37 | 9.67 | 1.75 (0.61; 5.04) | 0.300 | |
| Anti-infective pretreatment | 0.519 | 0.297 | 1.68 | 0.63 | 4.46 | |||
| Pretransplant serum creatinine > 2 mg/dL | −0.223 | 0.762 | 0.80 | 0.19 | 3.39 | |||
| Operative risk factors | ||||||||
| Choledochojejunostomy, primary | 0.983 | 0.071 | 2.67 | 0.92 | 7.76 | |||
| Transplantation time > 11 h | −3.022 | 0.678 | 0.05 | 0.00 | 77.12 | |||
| Intraoperative blood transfusion > 40 PRBC | 2.211 | 0.031 | 9.12 | 1.22 | 68.19 | 24.08 (2.72; 213.01) | 0.004 | |
| Split liver transplantation | 1.779 | 0.004 | 5.93 | 1.77 | 19.81 | 5.18 (1.40; 19.16) | 0.014 | |
| Donor-derived infection | 2.657 | <0.001 | 14.25 | 5.34 | 38.01 | 9.70 (3.24; 29.04) | <0.001 | |
| High-urgency transplantation | 1.406 | 0.022 | 4.08 | 1.22 | 13.60 | 1.72 (0.43; 6.95) | 0.448 | |
| Postoperative risk factors | ||||||||
| Bile leak | 1.690 | <0.001 | 5.42 | 2.50 | 11.73 | |||
| Relaparotomy, any reason | 1.960 | <0.001 | 7.10 | 2.85 | 17.69 | 4.62 (1.67; 12.77) | 0.003 | |
| Early re-transplantation | 1.156 | <0.001 | 3.18 | 1.86 | 5.42 | |||
| Posttransplant dialysis | 1.312 | 0.003 | 3.71 | 1.56 | 8.84 | 1.83 (0.69; 4.87) | 0.224 | |
| CMV viremia | 0.488 | 0.226 | 1.63 | 0.74 | 3.59 | |||
Variables with an increased hazard ratio for IFI: recipient age, intraoperative blood transfusion >40 PRBC, donor-derived infection, and relaparotomy. Variables excluded from the model (multicollinearity): bile leak and early re-transplantation. Abbreviations: SAPS III, simplified acute physiology score III; MELD, Model for End-Stage Liver Disease Score; IFI, invasive fungal infections; PRBC, packed red blood cells; CMV, cytomegalovirus; CI, confidence intervals; HR, hazard ratio.