الفهرس 
Liver transplantation in EgyptOnly 14 pages are availabe for public view
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Abstract
Egypt is a heavily populated country, with a high hepatitis C virus (HCV) infection prevalence of 26%. The high prevalence of chronic liver diseases in Egypt has led to increasing numbers of Egyptian patients suffering from end-stage liver disease. Liver transplantation (LT) is the most effective treatment for end-stage liver disease and selected primary hepatic malignancies. Infection is one of the leading causes of morbidity and mortality in liver transplant recipients. More than 65% of liver transplant recipients are infected in the first year after transplantation which is the leading cause of death in these patients.There are 3 time periods when specific infections are likely to occur after liver organ transplantation. The level of immunosuppression and environmental exposure, the patient’s susceptibility to infection which is strongly influenced by surgical factors, the dose, duration, and types of prophylaxis.In the early post-transplant period (less than 1 month), infection is most commonly bacterial, although the risk of fungal infection is high. This is the period when patients are highly immunosuppressed. Infections are primarily hospital acquired seen in other surgical patients such as enterococci, staphylococcus, gram-negative aerobes, anaerobes, or Candida species which represent 75% of fungal infections. They cause frequently intra-abdominal (cholangitis, liver, and other abdominal abscesses) and are typically observed during the post- transplant hospitalization.In the intermediate post-transplantation period (1-6months) after transplantation is the time during which classical infections appeared with transplantation. Opportunistic pathogens such as CMV, Pneumocystis carinii, Aspergillus species, Nocardia species, Toxoplasma gondii, and Listeria monocytogenes occur during this period.In the late post-transplantation period (more than 6 months) after transplantation, most transplant recipients do relatively well, suffering from the same infections seen in the general community. These include respiratory tract infections especially with influenza virus, streptococcus pneumonie and urinary tract infection. Infections are considered hospital acquired if they first appear 48 hours or more after hospital admission or within 30 days after discharge. Hospital acquired infections prolong the stay and increase both mortality and healthcare costs. It can occur in both adult and pediatric patients. Factors that promote infections among hospitalized patients include decreased immunity among patients; the increasing variety of medical procedures and invasive techniques creating potential routes of infection; and the transmission of drug resistant bacteria among crowded hospital populations, where poor infection control practices may facilitate transmission. Bloodstream infections followed by pneumonia and urinary tract infections are the frequently hospital acquired infections in children; while urinary tract infections are the commonest hospital acquired infections in adults. Infection control is the responsibility of all health care professionals, doctors, nurses, therapists and pharmacists. Standard precautions must be applied to all patients in all healthcare settings regardless of the suspected or confirmed presence of an infectious agent. This is the primary strategy in preventing transmission of infectious agents among patients and healthcare personnel. It has been concluded that the hospital acquired infections in liver transplantation recipients increases failure rates for liver transplantation; however, proper application of infection control measures can play a very crucial role in minimizing the risk of these infections.