Two-year post-transplantation cytomegalovirus DNAemia in asymptomatic kidney transplant recipients: incidence, risk factors, and outcome

2015 ◽  
Vol 17 (4) ◽  
pp. 497-509 ◽  
Author(s):  
B. Viot ◽  
I. Garrigue ◽  
B. Taton ◽  
T. Bachelet ◽  
J.-F. Moreau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Incidence Risk

Very Late-Onset Cytomegalovirus DNAemia in Asymptomatic Kidney Transplant Recipients: Incidence, Risk Factors and Outcome.

2014 ◽  
Vol 98 ◽  
pp. 765 ◽  
Author(s):  
L. Couzi ◽  
I. Garrigue ◽  
T. Bachelet ◽  
J. Moreau ◽  
J. Dechanet-Merville ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Late Onset ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Incidence Risk

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).

scholarly journals Surgical site complications in kidney transplant recipients: incidence, risk factors and outcomes in the modern era

2021 ◽  
Vol 64 (6) ◽  
pp. E669-E676
Author(s):  
Rebecca Bic Kay Wong ◽  
Michelle Minkovich ◽  
Olusegun Famure ◽  
Yanhong Li ◽  
Jason Young Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Incidence Risk ◽  
Surgical Site Complications ◽  
Modern Era

scholarly journals Incidence, Risk Factors, and Outcomes of Clostridium difficile Infections in Kidney Transplant Recipients

2018 ◽  
Vol 102 (9) ◽  
pp. 1576-1581 ◽  
Author(s):  
George J. Li ◽  
Justin Trac ◽  
Shahid Husain ◽  
Olusegun Famure ◽  
Yanhong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Incidence Risk

scholarly journals P1651HLA CW12 IN KIDNEY TRANSPLANT RECIPIENTS IS A NOVEL RISK FACTOR FOR THE DEVELOPMENT OF POST-TRANSPLANTATION DIABETES: A SINGLE-CENTRE RETROSPECTIVE STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nuvreen Phagura ◽  
Alice Culliford ◽  
Felicity Evison ◽  
Suzy Gallier ◽  
Jay Nath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Kidney Transplant ◽  
Hla Typing ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Single Centre ◽  
Post Transplantation ◽  
Hla Alleles ◽  
Hla Dq

Abstract Background and Aims Counselling kidney transplant candidates for their personalised risk of developing post-transplantation diabetes mellitus (PTDM) requires an understanding of risk factors. While some risk factors are well defined (e.g. age, ethnicity, body mass index), others like HLA typing are heterogeneously reported and lack consistency. The aim of this study was to investigate the association between HLA alleles and PTDM risk. Method Data was retrospectively extracted from hospital informatics systems for all kidney transplant recipients at a single-centre between 2007 and 2018, with patients excluded if they had pre-existing diabetes. Electronic patient records were then manually searched and records linked to various sources (e.g. NHS Blood and Transplant tissue typing, Hospital Episode Statistics, national death registry) to create a well-phenotyped cohort. Standard immunosuppression for all kidney transplant recipients during this study period was basiliximab induction with maintenance immunosuppression consisting tacrolimus, mycophenolate mofetil and low-dose corticosteroids. PTDM classification was aligned with International Consensus recommendations. Results Data was extracted for 1,560 kidney allograft recipients, with median follow up 5.4 years (IQR 2.7-8.7 years) up to October 2018. PTDM developed in 243 kidney transplant recipients (incidence 15.6%). A range of HLA alleles were examined (e.g. HLA-A, HLA-B, HLA-Cw, HLA-Bw, HLA-DR and HLA-DQ) but only the presence of HLA-Cw12 allele was associated with risk for PTDM (27.4% versus 14.3%, p<0.001) along with a selection of predominately recipient- and transplant related variables. In a logistic regression model, adjusted for all variables with a p-value <0.15 on univariate analysis, recipient HLA-Cw12 was found to be an independent risk factor associated with development of PTDM (Odds Ratio 1.793 [95% confidence interval 1.070-3.002], p=0.027) along with recipient female sex, recipient age, recipient BMI and recipient non-white ethnicity. Conclusion HLA-Cw12 allele in the kidney transplant recipient is independently associated with development of PTDM, although it is important to acknowledge association does not imply causality. This association has not been previously reported and requires validation and further investigation to understand any possible underlying biological mechanisms.

scholarly journals SP740LYMPHOCELES IN KIDNEY TRANSPLANT RECIPIENTS: INCIDENCE, RISK FACTORS AND IMPACT ON LONG-TERM OUTCOMES

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii392-iii392
Author(s):  
Lukas Lehner ◽  
Arnim Hohberger ◽  
LIsanne Marschke ◽  
Tanja Flaig ◽  
Fabian Halleck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Long Term Outcomes ◽  
Incidence Risk
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