P-2139. Association Between Respiratory Viral Detection, Mortality, and Postoperative Outcomes in Pediatric Liver Transplant Recipients

Abstract Background Children undergoing liver transplantation are at risk for perioperative complications, and respiratory viral detection during this period may influence post-surgical outcomes. The impact of viral infections on mortality and complications in pediatric liver transplant recipients remains unclear. Methods We conducted a retrospective cohort study (January 2020 - December 2023) at a tertiary university hospital in Bogotá, Colombia. Children undergoing liver transplantation were tested for respiratory viruses via multiplex PCR within 7 days before and 14 days after transplantation. The primary outcome was 28-day post-transplant mortality, while secondary outcomes included postoperative complications, length of hospital stay, and mechanical ventilation duration. Results A total of 169 children (median age 0.9 years) underwent liver transplantation. Respiratory viral detection occurred in 38.5% (65/169), with rhinovirus/enterovirus, adenovirus, and parainfluenza being the most common. Mortality was higher in children with viral detection (20% vs. 8.7%, aOR 2.56, 95% CI 1.02-6.42, P=0.03). Bacterial co-infection further increased mortality risk (aOR 2.64, 95% CI 1.06-6.61, P=0.03). Viral detection was also associated with increased surgical complications (aOR 2.18, 95% CI 1.12-4.27, P=0.02). No significant differences were observed in mechanical ventilation duration or hospital length of stay. Conclusion Respiratory viral detection in the peri-liver transplant period was associated with increased mortality and surgical complications in pediatric recipients. These findings highlight the need for preoperative viral screening and risk stratification to optimize post-transplant outcomes. Disclosures All Authors: No reported disclosures