Risk Factors for Surgical Site Infection in Kidney Transplant Recipients

2008 ◽  
Vol 29 (8) ◽  
pp. 771-773 ◽  
Author(s):  
Fernando G. Menezes ◽  
Sérgio B. Wey ◽  
Clóvis A. Peres ◽  
José O. Medina-Pestana ◽  
Luis Fernando A. Camargo
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Kidney Transplant ◽  
Graft Function ◽  
High Body Mass Index ◽  
Chronic Glomerulonephritis ◽  
Site Infection ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Epidemiologic Characteristics

We analyzed the epidemiologic characteristics and risk factors for surgical site infection (SSI) in kidney transplant recipients. From among 1,939 kidney transplant recipients, 120 with corresponding control subjects were evaluated in this study (1:1 ratio). Reoperation, chronic glomerulonephritis, acute graft rejection, delayed graft function, diabetes, and high body mass index were identified in the analysis as risk factors for SSI.

What is the impact of surgical site infection on graft function in kidney transplant recipients?

2010 ◽  
Vol 12 (5) ◽  
pp. 392-396 ◽  
Author(s):  
F.G. Menezes ◽  
S.B. Wey ◽  
C.A. Peres ◽  
J.O. Medina-Pestana ◽  
L.F.A. Camargo
Keyword(s):  
Surgical Site Infection ◽  
Kidney Transplant ◽  
Graft Function ◽  
Site Infection ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
The Impact

Risk Factors Associated With Decreasing Graft Function in Kidney Transplant Recipients.

2014 ◽  
Vol 98 ◽  
pp. 475
Author(s):  
C. Bucsa ◽  
G. Stefan ◽  
D. Tacu ◽  
C. Baston ◽  
M. Harza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Factors Associated

scholarly journals P1640COLONIZATION AND INFECTION WITH ESBL-PRODUCING AND CARBAPENEM-RESISTANT ENTEROBACTERIACIEAE IN KIDNEY TRANSPLANT RECIPIENTS: RISK FACTORS, IMPACT OF RENAL GRAFT FUNCTION AND USE OF HOSPITAL RESOURCES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alessandra Palmisano ◽  
Eleonora Salsi ◽  
Paride Fenaroli ◽  
Anna Maria Degli Antoni ◽  
Ilaria Gandolfini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Renal Graft ◽  
Carbapenem Resistant ◽  
Hospital Resources

Abstract Background and Aims ESBL-producing and carbapenem resistant (CR) Enterobacteriaceae are a common cause of severe infection, morbidity and mortality in kidney transplant recipients (KTR). Few studies have investigated the risk factors for ESBL-producing/CR Enterobacteriaceae colonization and infection in this group of patients, the effect of colonization and infection on KTR’s renal graft function, and the use of hospital resources. Method Retrospective follow-up study on a consecutive series of patients undergoing kidney transplantation at Parma University Hospital (Italy) between January-2016 and December-2018. We performed a multivariable-adjusted analysis of the predictive factor associated with MDR infection/colonization via general linear models for prevalence- and risk- ratio. Renal function (eGFR) decline was compared by mixed-effects random-coefficients models, hospital resources by negative binomial regression. Results We enrolled 180 KTR (mean recipient’s age: 52.4 [SD 12.4]; males 65%; mean donor’s age: 54.6 [SD 15.6]) and followed them up for 2-years post transplantation. Cumulative prevalence of colonization 3-months post-transplantation and cumulative incidence of infection were 26.1% and 9.4% for ESBL, and 4.4% and 1.6% for CR. ESBL colonization was associated with hemodialysis vs peritoneal dialysis (93% vs 70% non-colonized; adjusted RR 0.21 [95% CI: 0.06 to 0.98]), dialysis vintage (mean months: 65 vs 42; adjusted associated with being above the median, RR 2.17 [95% CI: 1.32 to 3.55]) and retention of ureteral stent for more than one month after transplant (28% vs 12%; adjusted RR 2.09 [95% CI: 1.27 to 3.44]) ; ESBL infection was associated with retention of ureteral stent (47% vs 13%; adjusted RR 4.89 [95% CI 2.11 to 11.35]) whereas CR colonization was associated with surgical complication during transplant admission (50% vs 15%; adjusted RR 4.61 [95% CI 1.28 to 16.66]). Two patients (both with CR) died over the study follow-up, whereas none of the patients lost the graft. CR infection was associated lower baseline (3-months post-transplantation) eGFR compared to the other groups (-28.4mL/min/1.73m2 [95% CI: -50.5 to -6.3]); a numerically more rapid decline (up to - 5mL/min/year) of eGFR, albeit not statistically significant, was observed in patients with CR colonization compared to non-colonized at 2 years of follow-up. In comparison with non-colonized patients, adjusted mean days of carbapenem treatment in ESBL/CR colonized/infected was 5.7 vs 0.7 (P=0.003); length-of-hospital stay 5.8 vs 1.0 (P=0.055); days on drug-resistant-infection intravenous-outpatient-therapy 20.7 vs 0.1 (P= 0.008). Conclusions The study shows that ESBL and CR colonization and infection in KTR are statistically associated with longer hemodialysis vintage, urological procedures, and surgical complications. They cause an increase in the hospital resources use and may jeopardize transplant outcomes.

scholarly journals Incidence, Risk Factors, and Outcomes of Kidney Transplant Recipients Treated With Both Basiliximab and Antithymocyte Globulin

2020 ◽  
Vol 7 ◽  
pp. 205435812096406
Author(s):  
Rachel Jeong ◽  
Robert R. Quinn ◽  
Krista L. Lentine ◽  
Pietro Ravani ◽  
Feng Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Graft Failure ◽  
Antithymocyte Globulin ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Incidence Risk

Background: Kidney transplant recipients are given induction therapy to rapidly reduce the immune response and prevent rejection. Guidelines recommend that an interleukin-2 receptor antibody (basiliximab) be the first-line agent and that a lymphocyte-depleting agent (antithymocyte globulin [ATG]) be reserved for those at high immunologic risk. Objective: To determine the incidence, risk factors, and outcomes for patients who receive both basiliximab and ATG for induction compared to either agent alone. Design: Retrospective cohort study. Setting: We used the transplant electronic medical record at the University of Alberta Hospital in Edmonton, Canada. Patients/samples/participants: We included incident adult kidney transplant recipients from 2013 to 2018. Measurements: We measured baseline characteristics, type, and dose of induction therapy used, estimated glomerular filtration rate (eGFR) at 1-year posttransplant, and outcomes of all-cause graft failure, death-censored graft failure, all-cause mortality, and death with a functioning graft. Methods: Differences between induction groups were compared using chi-square test for categorical variables and Kruskal-Wallis tests for continuous variables. We performed multivariable logistic regression modeling with type of induction therapy as the dependent variable and the case-level factors as the predictors (adjusted odds ratio). We estimated the Kaplan-Meier failure functions and used log-rank tests to assess statistical significance of differences in unadjusted incidence across induction therapy types. We compared cumulative incidence functions using a Fine and Gray competing risk regression model. Results: In all, 430 kidney transplant recipients were followed for a mean of 3.9 years (standard deviation 1.5). Of these, 71% (n = 305) received basiliximab alone, 22% (n = 93) received ATG alone, and 7% (n = 32) received both basiliximab and ATG. After adjusting for age and sex, compared to the basiliximab alone group, patients were more likely to receive dual-induction therapy if they were sensitized (calculated panel reactive antibody ≥80%), had diabetes mellitus or peripheral vascular disease, or experienced delayed graft function. Compared to the ATG alone group, the dual-induction therapy group had worse graft function at 1 year (mean eGFR 42 vs. 59 mL/min/1.73 m2, P = .0008) and an increased risk of all-cause graft failure (31% vs. 13%, P = .02) and death-censored graft failure (16% vs. 4%, P = .03). Limitations: There is a risk of confounding by indication, as patients who received dual-induction therapy likely had worse outcomes due to the indication for dual-induction therapy (such as delayed graft function). Conclusions: In our study, 1 out of 10 recipients who were treated with basiliximab also received ATG for induction therapy. These patients experienced worse outcomes than those treated with ATG alone. Trial registration: Not applicable (cohort study).

Delayed graft function in kidney transplant recipients: risk factors and short-term outcome

2002 ◽  
Vol 34 (1) ◽  
pp. 352-354 ◽  
Author(s):  
R.A Iglesias-Márquez ◽  
E.A Santiago-Delpı́n ◽  
E Zayas ◽  
Z González-Caraballo ◽  
L Morales-Otero
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome
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