Frailty is Predictive of Early Post-Transplant Infection in Older Renal Transplant Recipients
1Section of Infectious Diseases, Yale School of Medicine, New Haven, CT
2College of Medicine, Central Michigan University, Mount Pleasant, MI
3Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, CT
4Section of Nephrology, Yale School of Medicine, New Haven, CT
5Department of Anesthesiology, Yale School of Medicine, New Haven, CT.
Meeting: 2018 American Transplant Congress
Abstract number: 444
Keywords: Elderly patients, Infection, Kidney transplantation, Outcome
Session Information
Session Name: Concurrent Session: Kidney Infectious - Pot-Pourri
Session Type: Concurrent Session
Date: Tuesday, June 5, 2018
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: Room 608/609
Background: Frailty is predictive of postoperative morbidity, including infections in older surgical patients. It is not known if frailty is associated with post-operative infections in patients undergoing renal transplantation. This study attempts to answer this question.
Methods: We performed a retrospective, observational cohort study of older patients (age ≥65) who underwent primary renal transplant (RT) in a single transplant center from January 1, 2013 to April 1, 2017. The modified frailty index (mFI) was calculated based on 11 risk factors. The mFI scores were categorized as follows: 0-1 (fit), 2 (mildly frail) and ≥ 3 (moderately-severely frail). Outcomes measured were: 30-day mortality, 30-day post-transplant infection (PTI), 30-day readmission, and 200-day PTI. The association of frailty with RT outcomes was determined using multivariate logistic regression adjusting for confounders.
Results: Eighty-three RT recipients met inclusion criteria. Of these, 60 (72%) were men and mean age was 70 years (± 3.93). The mean time on dialysis was 4.5 years (± 2.9). The distribution of mFI scores was as follows: 0-1 (37%), 2 (25%), and ≥ 3 (37%). No patients died within 30-day of RT. Rates of 30-day PTI and readmission were 14% and 30%, respectively. Infection within 200 days of RT occurred in 45%. Patients with mFI score of ≥3 had a higher risk of 30-day PTI (OR=12.70, p=0.029) when compared with mFI score of 0-1. Both mFI scores of 2 and ≥3 were associated with increased risk of infections within 200 days of RT (OR=5.00 and 5.28, respectively, p<0.05). The risk for 30-day readmission was higher among those with mFI scores of 2 and ≥ 3 (OR= 5.66 and 5.18, respectively, p< 0.05) compared with mFI score of 0-1.
Conclusion: Our study shows that frail older RT recipients are at an increased risk for early PTI. Future studies utilizing larger databases are needed to validate our findings. Strategies that improve frailty status of older RT candidates should be evaluated for their impact on the rate of PTI.
CITATION INFORMATION: Malinis M., Ogbejesi C., Luo J., Zhang Y., Asch W., Deshpande R., Akhtar S. Frailty is Predictive of Early Post-Transplant Infection in Older Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Malinis M, Ogbejesi C, Luo J, Zhang Y, Asch W, Deshpande R, Akhtar S. Frailty is Predictive of Early Post-Transplant Infection in Older Renal Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/frailty-is-predictive-of-early-post-transplant-infection-in-older-renal-transplant-recipients/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress