The use of liver grafts from donors with bacterial meningitis

Background. The shortage of suitable donors for transplantation is a worldw ide problem. The use of cadaveric donors with bacterial meningitis may be a ssociated with an increased risk of sepsis. We report the results of orthot opic liver transplantation (OLT) from 33 such donors between 1989 and 1999. Methods. The hospital records of recipients from cadaveric donors with meni ngitis (study group) were retrospectively reviewed and compared with matche d recipients from cadaveric donors dying from causes other than meningitis (recipient-matched control group). Results. A total of 34 recipients underwent 21 whole, 10 reduced, and 3 spl it liver transplants from 33 cadaveric donor livers with bacterial meningit is. The donor meningitis pathogens were Neisseria meningitidis (n=14), Stre ptococcus pneumoniae (n=4), Haemophilus influenzae (n=l), Streptococcus spe cies (n=2), and unknown (n=12). Twenty-seven patients had an elective OLT a nd seven patients had an emergency OLT. Adequate antimicrobial therapy befo re organ procurement and after transplant was administrated. The mean postt ransplant follow-up was 37 months (range: 1 day-106 months). There was no d ifference in recipient and graft survival rates between the study and the r ecipient-matched groups. In the study group, there were no infectious compl ications caused by the meningeal pathogens. Overall patient survival rates were 79%, 76%, 72%, and 72% at 1, 6, 12, and 60 months, respectively. Graft survival was 77%, 70%, 65%, and 65% at 1, 6, 12, and 60 months, respective ly. The survival rate in elective cases was significantly better than emerg ency cases (P <0.05). Conclusion. Liver transplantation from donors with bacterial meningitis is a safe procedure provided both donors and recipients receive adequate antim icrobial therapy.