Beyond the First Year : Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation
Copyright © 2024 Esnault, Hoisnard, Peiffer, Fihman, Fourati, Angebault, Champy, Gallien, Attias, Morel, Grimbert, Melica and Matignon..
Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1 year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1 year. Among 1066 KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0-45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3 years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Transplant international : official journal of the European Society for Organ Transplantation - 37(2024) vom: 30., Seite 12065 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Esnault, V [VerfasserIn] |
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| Links: |
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| Themen: |
Herpes zoster |
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| Anmerkungen: |
Date Completed 13.03.2024 Date Revised 13.03.2024 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.3389/ti.2024.12065 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1 year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1 year. Among 1066 KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0-45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3 years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections | ||
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| 700 | 1 | |a Peiffer, B |e verfasserin |4 aut | |
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| 700 | 1 | |a Fourati, S |e verfasserin |4 aut | |
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| 700 | 1 | |a Champy, C |e verfasserin |4 aut | |
| 700 | 1 | |a Gallien, S |e verfasserin |4 aut | |
| 700 | 1 | |a Attias, P |e verfasserin |4 aut | |
| 700 | 1 | |a Morel, A |e verfasserin |4 aut | |
| 700 | 1 | |a Grimbert, P |e verfasserin |4 aut | |
| 700 | 1 | |a Melica, G |e verfasserin |4 aut | |
| 700 | 1 | |a Matignon, M |e verfasserin |4 aut | |
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