Impact of Organ Donor Infections on Kidney Transplant Recipient Outcomes
1Department of Medicine, Division of Infectious Diseases, Loyola University Medical Center, Maywood, IL, 2Department of Pharmacy, Loyola University Medical Center, Maywood, IL, 3Department of Medicine, Division of Transplant Nephrology, Loyola University Medical Center, Maywood, IL
Meeting: 2020 American Transplant Congress
Abstract number: B-195
Keywords: Cadaveric organs, Infection, Kidney transplantation
Session Information
Session Name: Poster Session B: Kidney Infectious Excluding Polyoma & Viral Hepatitis
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Donor-derived infections can lead to significant morbidity and mortality in organ transplant recipients. There is variability by center on treatment of positive donor cultures and insufficient data on associated outcomes. In this study, we examined how positive donor cultures are treated in recipients of deceased donor renal transplants and the impact on graft and patient survival.
*Methods: A retrospective chart review of all renal transplant recipients with positive blood, urine, or perfusion fluid donor cultures was performed from January 1, 2017 to December 31, 2018. Patients were excluded if they were <18 years of age, there was insufficient documentation in the medical record, or they had a simultaneous organ transplant (n=9).
*Results: There were 40 renal transplant recipients with positive donor cultures in the cohort. The mean age was 50.6, with 58% male recipients. Twenty-nine patients (73%) received an infectious diseases (ID) consult to recommend antimicrobial therapy. There were 10 donors with positive blood cultures (25%), 17 donors with positive perfusion fluid cultures (42.5%), and 15 donors with positive urine cultures (37.5%). Twenty-six recipients received effective therapy targeting the donor culture (65%). The mean duration of effective treatment for positive donor cultures was 14.8 days and the mean length of stay for all recipients was 6.6 days. Presence of an ID consult was associated with significantly more effective treatment for donor cultures (p=0.001), however effective treatment was not associated with a decrease in clinical outcomes such as graft loss, mortality, Clostridium difficileinfection, or re-admission rates within 6 months of transplant.
*Conclusions: At our institution, most renal transplant patients with positive donor cultures receive effective antimicrobials to target these pathogens and most receive an ID consult. More data is needed to determine the optimal route and duration of therapy. The rate of complications for our patients was low, perhaps due to most patients receiving effective therapy.
To cite this abstract in AMA style:
Santarossa M, Muran C, Sanchez S, Heinrich L, Yoo J, Albarillo F, Akkina S, Clark N, Reid G. Impact of Organ Donor Infections on Kidney Transplant Recipient Outcomes [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-organ-donor-infections-on-kidney-transplant-recipient-outcomes/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress