Impact of Late and Recurrent Acute Graft Pyelonephritis on Long-Term Kidney Graft Outcomes
1CRT2I, Université de Nantes, Nantes, France, 2Service de Néphrologie et immunologie clinique, CHU de Nantes, Nantes, France, 3INSERM UMR 1246-SPHERE, Université de Nantes, Nantes, France
Meeting: 2022 American Transplant Congress
Abstract number: 304
Keywords: Infection, Kidney transplantation, Outcome
Topic: Clinical Science » Kidney » 46 - Kidney Complications: Non-Immune Mediated Late Graft Failure
Session Information
Session Name: Kidney Complications: Non-Immune Mediated Late Graft Failure
Session Type: Rapid Fire Oral Abstract
Date: Monday, June 6, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 6:40pm-6:50pm
Location: Hynes Room 310
*Purpose: While Urinary tract infections are the most common infections in kidney transplant recipients, the impact of late acute graft pyelonephritis (AGPN) on graft outcomes remains unknown. Our study was performed to more precisely evaluate the long-term impact of AGPN.
*Methods: We included 9052 kidney and combined kidney-pancreas recipients who underwent transplantation between 2008 and 2018 from a French multicenter cohort. The relationships between AGPN and patient and graft survival were analyzed with a time-dependent multivariate Cox model.
*Results: The cumulative incidence of AGPN was 20.9%. A first episode of early AGPN is associated with a non-significant increase in the risk of graft failure (hazard ratio [HR], 1.27; 95% confidence interval [95% CI], 0.90 to 1.79). Though, cumulative number of AGPN episodes (HR = 1.51; 95% CI, 0.89 to 2.57 for two episodes and HR = 2.08; 95% CI, 1.17 to 3.69 for three or more episodes) is associated with an increase risk of graft failure. In contrast, when the first episode of AGPN occurred late (i.e., 6 months post transplantation), the risk of graft failure is significantly increased (HR = 2.25; 95% CI, 1.65 to 3.07), and this risk remains relatively stable with the recurrence of late AGPN episodes. The results were similar for the risk of graft failure or loss and the risk of patient death.
*Conclusions: For the first time, we could demonstrate the impact of late and recurrent AGPN occurring six months after transplantation on patient survival, graft survival and combined patient-graft survival, in a time manner. We report that late AGPN and recurrent late AGPN are both risk factors for a poor long-term graft outcome and mortality. These infections should therefore not be considered benign and as soon as the first episode of AGPN occurs, patients should be closely monitored to limit the risk of recurrence.
To cite this abstract in AMA style:
Pacaud M, Colas L, Kerleau C, Borgne FLe, Giral M, Brouard S, Dantal J. Impact of Late and Recurrent Acute Graft Pyelonephritis on Long-Term Kidney Graft Outcomes [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-late-and-recurrent-acute-graft-pyelonephritis-on-long-term-kidney-graft-outcomes/. Accessed October 10, 2024.« Back to 2022 American Transplant Congress