Burden of Infectious Complications after Upper Extremity Allotransplantation: A Matched Cohort Study
1Department of Transplantation, Nephrology and Clinical Immunology, Hospices Civils de Lyon (HCL), Lyon, France
2Department of Infectious Diseases and Tropical Medicine, HCL, Lyon, France
3Claude Bernard Lyon 1 University, Lyon, France
4Department of Transplantation, HCL, Lyon, France
5Department of Surgery, University of Cagliari, Cagliari, Italy
6Department of Dermatology, HCL, Lyon, France
7Clinique du Parc, Lyon, France
8Department of Urology and Transplantation, HCL, Lyon, France
9Infection Control and Epidemiology Unit, HCL, Lyon, France
10INSERM U1111, International Center for Infectiology Research, Lyon, France.
Meeting: 2018 American Transplant Congress
Abstract number: B367
Keywords: Immunosuppression, Infection, Kidney transplantation
Session Information
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
This study aimed to assess the infectious risk after upper extremity allotransplantation (UEA), a non-vital transplantation procedure requiring lifelong immunosuppression. A matched cohort study was conducted among UEA and kidney transplant (KT) recipients from the “International Registry on Hand and Composite Tissue Transplantation” (IRHCTT) and the French DIVAT database. All UEA recipients between 1998 and 2016 were matched with KT recipients (1:5), according to age, sex, CMV donor/recipient serostatus and type of induction. Incidence and characteristics of infections were analyzed at three posttransplant periods (0-6 months, 7-12 months, >12 months). Sixty-one UEA recipients were matched with 305 KT recipients and followed for 2583±1876 and 2230±1792 days, respectively (p=0.16). During follow-up, UEA recipients had more acute rejection episodes than KT recipients (1.3±1.6 vs 0.4±0.7, p<0.01). Incidence rate of infectious events was higher in UEA recipients than in KT recipients during the first 6 months posttransplant (3.27 vs 1.95 events/1000 transplant-days, p=0.01). Thereafter, incidence rates of infections did not significantly differ: 0.61 vs 0.45 events/1000 transplant-days (7th-12th month, p=0.5) and 0.15 vs 0.21 events/1000 transplant-days (>12th month, p=0.11), respectively. Distribution of sites of infections was significantly different, with mucocutaneous infections predominating after UEA, urinary tract infections and pneumonia predominating after KT. In conclusion, infections are more frequent among UEA recipients than in KT recipients during the first 6 months posttransplant. After the first 6 months posttransplant, incidence rate of infections after UEA is low, at worst equivalent to that observed in young KT recipients. Pattern of infections is different, with less severe infections after UEA.
CITATION INFORMATION: Conrad A., Petruzzo P., Kanitakis J., Gazarian A., Badet L., Vanhems P., Thaunat O., Morelon E., Sicard A. Burden of Infectious Complications after Upper Extremity Allotransplantation: A Matched Cohort Study Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Conrad A, Petruzzo P, Kanitakis J, Gazarian A, Badet L, Vanhems P, Thaunat O, Morelon 10E, Sicard 10A. Burden of Infectious Complications after Upper Extremity Allotransplantation: A Matched Cohort Study [abstract]. https://atcmeetingabstracts.com/abstract/burden-of-infectious-complications-after-upper-extremity-allotransplantation-a-matched-cohort-study/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress