Characterizing the landscape and impact of infections following kidney transplantation
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons..
Infections remain a major threat to successful kidney transplantation (KT). To characterize the landscape and impact of post-KT infections in the modern era, we used United States Renal Data System (USRDS) data linked to the Scientific Registry of Transplant Recipients (SRTR) to study 141 661 Medicare-primary kidney transplant recipients from January 1, 1999 to December 31, 2014. Infection diagnoses were ascertained by International Classification of Diseases, Ninth Revision (ICD-9) codes. The cumulative incidence of a post-KT infection was 36.9% at 3 months, 53.7% at 1 year, and 78.0% at 5 years. The most common infections were urinary tract infection (UTI; 46.8%) and pneumonia (28.2%). Five-year mortality for kidney transplant recipients who developed an infection was 24.9% vs 7.9% for those who did not, and 5-year death-censored graft failure (DCGF) was 20.6% vs 10.1% (P < .001). This translated to a 2.22-fold higher mortality risk (adjusted hazard ratio [aHR]: 2.15 2.222.29 , P < .001) and 1.92-fold higher DCGF risk (aHR: 1.84 1.911.98 , P < .001) for kidney transplant recipients who developed an infection, although the magnitude of this higher risk varied across infection types (for example, 3.11-fold higher mortality risk for sepsis vs 1.62-fold for a UTI). Post-KT infections are common and substantially impact mortality and DCGF, even in the modern era. Kidney transplant recipients at high risk for infections might benefit from enhanced surveillance or follow-up to mitigate these risks.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2021 |
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Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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Enthalten in: |
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 21(2021), 1 vom: 14. Jan., Seite 198-207 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Jackson, Kyle R [VerfasserIn] |
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Links: |
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Themen: |
Journal Article |
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Anmerkungen: |
Date Completed 18.06.2021 Date Revised 07.03.2023 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1111/ajt.16106 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM310861594 |
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520 | |a © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons. | ||
520 | |a Infections remain a major threat to successful kidney transplantation (KT). To characterize the landscape and impact of post-KT infections in the modern era, we used United States Renal Data System (USRDS) data linked to the Scientific Registry of Transplant Recipients (SRTR) to study 141 661 Medicare-primary kidney transplant recipients from January 1, 1999 to December 31, 2014. Infection diagnoses were ascertained by International Classification of Diseases, Ninth Revision (ICD-9) codes. The cumulative incidence of a post-KT infection was 36.9% at 3 months, 53.7% at 1 year, and 78.0% at 5 years. The most common infections were urinary tract infection (UTI; 46.8%) and pneumonia (28.2%). Five-year mortality for kidney transplant recipients who developed an infection was 24.9% vs 7.9% for those who did not, and 5-year death-censored graft failure (DCGF) was 20.6% vs 10.1% (P < .001). This translated to a 2.22-fold higher mortality risk (adjusted hazard ratio [aHR]: 2.15 2.222.29 , P < .001) and 1.92-fold higher DCGF risk (aHR: 1.84 1.911.98 , P < .001) for kidney transplant recipients who developed an infection, although the magnitude of this higher risk varied across infection types (for example, 3.11-fold higher mortality risk for sepsis vs 1.62-fold for a UTI). Post-KT infections are common and substantially impact mortality and DCGF, even in the modern era. Kidney transplant recipients at high risk for infections might benefit from enhanced surveillance or follow-up to mitigate these risks | ||
650 | 4 | |a Journal Article | |
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700 | 1 | |a Motter, Jennifer D |e verfasserin |4 aut | |
700 | 1 | |a Bae, Sunjae |e verfasserin |4 aut | |
700 | 1 | |a Kernodle, Amber |e verfasserin |4 aut | |
700 | 1 | |a Long, Jane J |e verfasserin |4 aut | |
700 | 1 | |a Werbel, William |e verfasserin |4 aut | |
700 | 1 | |a Avery, Robin |e verfasserin |4 aut | |
700 | 1 | |a Durand, Christine |e verfasserin |4 aut | |
700 | 1 | |a Massie, Allan B |e verfasserin |4 aut | |
700 | 1 | |a Desai, Niraj |e verfasserin |4 aut | |
700 | 1 | |a Garonzik-Wang, Jacqueline |e verfasserin |4 aut | |
700 | 1 | |a Segev, Dorry L |e verfasserin |4 aut | |
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