Transplantation and immigration : Comparing infectious complications and outcomes between foreign-born and US-born kidney transplant recipients in Minnesota
© 2023 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC..
BACKGROUND: Foreign-born kidney transplant recipients (FBKTRs) are at increased risk for reactivation of latent infections that may impact outcomes. We aimed to compare the etiology of infections and outcomes between FBKTR and United States KTRs (USKTR).
METHODS: We performed a retrospective study of patients who underwent kidney transplantation between January 1, 2014 and December 31, 2018 at two transplant centers in Minnesota. Frequency and etiology of infections as well as outcomes (graft function, rejection, and patient survival) at 1-year post-transplant between FBKTR and USKTR were compared.
RESULTS: Of the 573 transplant recipients, 124 (21.6%) were foreign-born and 449 (78.4%) US-born. At least one infection occurred in 411 (71.7%) patients (38.2% bacterial, 55% viral, 9.4% fungal). Viral infections were more frequent in FBKTR, particularly BK viremia (38.7% vs. 21.2%, p < .001). No statistical differences were found for bacterial or fungal infections; no parasitic infections were identified in either group. No geographically-restricted infections were noted aside from a single case of Madura foot in a FBKTR. Rejection episodes were more common in USKTR (p = .037), but stable/improving graft function (p = .976) and mortality (p = .451) at 1-year posttransplantation were similar in both groups. After adjusting for covariates, previous transplantation was associated with a higher number of infections (IRR 1.35, 95% confidence intervals 1.05-1.73, p = .020).
CONCLUSION: Although viral infections were more frequent in FBKTR, overall frequency and etiology of most infections and outcomes were similar between FBKTR and USKTR suggesting that comprehensive transplant care is providing timely prevention, diagnosis, and treatment of latent infections in FBKTR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Transplant infectious disease : an official journal of the Transplantation Society - 25(2023), 2 vom: 01. Apr., Seite e14039 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ordaya, Eloy E [VerfasserIn] |
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| Links: |
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| Themen: |
Immigration health |
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| Anmerkungen: |
Date Completed 11.04.2023 Date Revised 02.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/tid.14039 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Ordaya, Eloy E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Transplantation and immigration |b Comparing infectious complications and outcomes between foreign-born and US-born kidney transplant recipients in Minnesota |
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| 500 | |a Date Revised 02.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: Foreign-born kidney transplant recipients (FBKTRs) are at increased risk for reactivation of latent infections that may impact outcomes. We aimed to compare the etiology of infections and outcomes between FBKTR and United States KTRs (USKTR) | ||
| 520 | |a METHODS: We performed a retrospective study of patients who underwent kidney transplantation between January 1, 2014 and December 31, 2018 at two transplant centers in Minnesota. Frequency and etiology of infections as well as outcomes (graft function, rejection, and patient survival) at 1-year post-transplant between FBKTR and USKTR were compared | ||
| 520 | |a RESULTS: Of the 573 transplant recipients, 124 (21.6%) were foreign-born and 449 (78.4%) US-born. At least one infection occurred in 411 (71.7%) patients (38.2% bacterial, 55% viral, 9.4% fungal). Viral infections were more frequent in FBKTR, particularly BK viremia (38.7% vs. 21.2%, p < .001). No statistical differences were found for bacterial or fungal infections; no parasitic infections were identified in either group. No geographically-restricted infections were noted aside from a single case of Madura foot in a FBKTR. Rejection episodes were more common in USKTR (p = .037), but stable/improving graft function (p = .976) and mortality (p = .451) at 1-year posttransplantation were similar in both groups. After adjusting for covariates, previous transplantation was associated with a higher number of infections (IRR 1.35, 95% confidence intervals 1.05-1.73, p = .020) | ||
| 520 | |a CONCLUSION: Although viral infections were more frequent in FBKTR, overall frequency and etiology of most infections and outcomes were similar between FBKTR and USKTR suggesting that comprehensive transplant care is providing timely prevention, diagnosis, and treatment of latent infections in FBKTR | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a immigration health | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a transplant infectious diseases | |
| 650 | 4 | |a tropical medicine | |
| 700 | 1 | |a Shaughnessy, Megan |e verfasserin |4 aut | |
| 700 | 1 | |a Elkin, Baila |e verfasserin |4 aut | |
| 700 | 1 | |a Husmann, Rachel L |e verfasserin |4 aut | |
| 700 | 1 | |a Stauffer, Jacob C |e verfasserin |4 aut | |
| 700 | 1 | |a Luengas, Elizabeth M |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Bickey H |e verfasserin |4 aut | |
| 700 | 1 | |a Tessier, Katelyn M |e verfasserin |4 aut | |
| 700 | 1 | |a Walker, Patricia F |e verfasserin |4 aut | |
| 700 | 1 | |a Stauffer, William M |e verfasserin |4 aut | |
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