Microbiologic Contamination of Intraoperative Blood Salvaged During Liver Transplantation

[Guest guest]

doi:10.1016/j.transproceed.2007.05.005 Copyright © 2007 Elsevier Inc. All rights reserved.

Microbiologic Contamination of Intraoperative Blood Salvaged During Liver Transplantation

P. Feltraccoa, , E. Michielettoa, S. Barbieria, E. Serraa, S. Rizzia, F. Salvaterraa, U. Cillob and C. Oria aDepartment of Pharmacology and Anesthesiology University Hospital of Padova, Padova, ItalybDepartment of Surgical Science University Hospital of Padova, Padova, Italy. Available online 8 August 2007.

Abstract Bacterial contamination is one of the potential risks of blood salvage and reinfusion during orthotopic liver transplantation (OLT) because cell-saver machines lack antibacterial protection devices. This study was designed to analyze the potential bacterial contamination of blood salvaged during OLT; a secondary end point was to evaluate whether reinfusion of potentially contaminated blood may have been responsible for clinically manifested infective complications in the same patient. After induction of anesthesia, a blood sample was drawn from the central venous catheter (CVC) immediately after its positioning, to exclude potential coexisting hematic contamination of the recipient. During the procedure, 2 other samples of salvaged blood were collected for bacteriological analysis. Twenty-six of 38 samples of salvaged blood were positive for microorganisms, whereas 12 did not reveal the presence of infectious agents. In 19 of 26 positive samples, Staphylococcus species (73%) were isolated with only 2 of 38 samples drawn from CVC being contaminated. Candida Albicans was cultured in 2 samples. The high percentage (73%) of coagulase-negative Staphylococci indicates that blood contamination could have been caused by microorganisms from the air or suctioned from contact surfaces and the surgical field. Although almost 70% of processed and reinfused units tested positive for microbes, none of the postoperative blood cultures (at day 1 and day 3) revealed growth of the same species, not even in the 2 patients who had positive CVC cultures after induction of anesthesia.

Address reprint requests to Paolo Feltracco, Department of Pharmacology and Anesthesiology, Via Giustiniani 1 35128 Padova, Italy.

Transplantation Proceedings Volume 39, Issue 6, July-August 2007, Pages 1889-1891