Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 18 5 2026 10 05 685 693 EN Fereshteh Ghiasvand Department of Infectious Diseases, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Zahra Jahani Department of Infectious Diseases, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Jafarian Department of Liver Transplant and Hepatobiliary Surgery, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Elham Madreseh Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Zahra Ahmadinejad Department of Infectious Diseases, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2026 05 30 2026 09 14 Background and Objectives: Surgical site infection (SSI) is an important complication among liver transplant (LT) recipients. This study aimed to determine the prevalence, risk factors and microbial etiologies of SSI in LT recipients. Materials and Methods: This retrospective observational study was conducted at a tertiary care hospital, Imam Khomeini Hospital complex, Tehran, Iran, between 2015 and 2020. Clinical data were collected from password-protected database. Results: A total of 200 patients were included, of whom 121 (60.5%) were men. The mean age was 43.85 ± 14.59 years. Ninety-six patients (48%) developed SSI. broad-spectrum antibiotics use (p=.005), preoperative corticosteroids and immunosuppressive therapy (P = .000), Prolonged ICU stay (P=.000), and higher MELD score before transplantation (P = .002) were significantly associated with SSI. Graft rejection and one-year mortality rates were higher among patients with SSI; however, these differences were not statistically significant. SSI was also more common among patient with diabetes mellitus, other non-hepatic comorbidities, moderate-to-severe ascites, and those receiving piperacillin-tazobactam prophylaxis after surgery. The most frequently isolated microorganisms from SSI culture were Klebsiella pneumoniae (25%), Enterococcus spp. (22.9%) and Escherichia coli (16.6%). Conclusion: SSI remains a common complication among LT in our canter and should be suspected in patients presenting with infection during the first postoperative month. Recipients with advanced liver disease, prolonged ICU stay, preoperative immunosuppressive therapy, and post-transplant hemodialysis may require monitoring. https://ijm.tums.ac.ir/index.php/ijm/article/view/6226 https://ijm.tums.ac.ir/index.php/ijm/article/download/6226/1929