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

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:21

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

Beteiligte Personen:

Jackson, Kyle R [VerfasserIn]
Motter, Jennifer D [VerfasserIn]
Bae, Sunjae [VerfasserIn]
Kernodle, Amber [VerfasserIn]
Long, Jane J [VerfasserIn]
Werbel, William [VerfasserIn]
Avery, Robin [VerfasserIn]
Durand, Christine [VerfasserIn]
Massie, Allan B [VerfasserIn]
Desai, Niraj [VerfasserIn]
Garonzik-Wang, Jacqueline [VerfasserIn]
Segev, Dorry L [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 18.06.2021

Date Revised 07.03.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/ajt.16106

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310861594