Session Name: All Infections (Excluding Kidney & Viral Hepatitis)
Session Date & Time: None. Available on demand.
*Purpose: Solid organ transplant recipients are at increased risk for cryptococcosis, which is known to decrease their survival. Adherence to recommended management strategies and outcomes in this population have primarily been researched in single-center or small multicenter studies. The purpose of our study is to utilize an extensive dataset of end-stage renal disease patients in the United States, the United States Renal Data System (USRDS), to describe cryptococcosis in kidney transplant recipients.
*Methods: We analyzed demographic, transplant, and hospitalization data of USRDS renal transplant recipients first hospitalization for cryptococcosis after transplantation in the period from January 2010 to December 2016.
*Results: The dataset contained information for 1,204,196 hospitalizations in 213,070 kidney transplant recipients. Among them, we identified 952 patients who had 2,193 cryptococcosis hospitalizations. The median time from the earliest transplant to first cryptococcosis hospitalization was 3.5 years (IQR 1.3-8.6). The mean number of hospitalizations per patient was 2.3, and the median length of stay for the index hospitalization was 11 days. Forty-four percent of patients had admission to an intensive care unit during their first hospitalization with a mean length of stay of 5.5 days. During the index hospitalization, 66% of patients had one or more lumbar punctures. The 30- and 90-day readmission rate after index hospitalization was 33.6% and 43.2%, respectively. Seventy-seven patients (8%) died during the index hospitalization.
*Conclusions: Cryptococcosis is an important contributor to morbidity and mortality among kidney transplant recipients. In future research, we intend to use provider, drug, and claims data to study patterns of care preceding cryptococcosis diagnosis and its long-term impact.
|Characteristic||Cryptococcosis N (%)||Alive N (%)||Died N (%)||P|
|Male||634 (66.6)||580 (66.2)||54 (70.1)||0.4*|
|Age at diagnosis, years, mean (IQR)||60.1 (53.3-68.2)||59.9 (53.2-68.1)||62.3 (55.5-69.8)||0.07**|
|Time posttransplant, years, median (IQR)||3.5 (1.3-8.6)|
|Lumbar punctures||629 (66)||579 (66.1)||50 (65.9)||0.8*|
|Lung procedures||250 (26.2)||222 (25.3)||28 (36.3)||0.036*|
|ICU admission||424 (44.5)||359 (41)||65 (84.4)||<0.001*|
To cite this abstract in AMA style:Cervera-Hernandez ME, Yoon HA, Pirofski L, Hemmige V. Cryptococcosis in Renal Transplant Recipients —An Analysis of United States Renal Data System Data [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/cryptococcosis-in-renal-transplant-recipients-an-analysis-of-united-states-renal-data-system-data/. Accessed June 12, 2021.
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