Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Currently, kidney allograft survival improved, use of depleting antibodies increased and
donor and recipient became older. In this context, no recent study reported epidemiology of opportunistic infections (OI) after kidney transplant neither the impact of OI on patient and allograft survival.
We performed a monocentric retrospective study including kidney allografts recipients engrafted between January 2008 and December 2013 besides primary non-function. Endpoints were OI epidemiology, patient and kidney allograft survivals and risk factors of OI. Control group included all the others kidney recipients.
We included 538 kidney transplantations in 538 patients. Incidence of OI was 14.8% (N=80). The leading cause was viral (N=54; 67.5%) with N=21 herpes zoster (27.5%) and N=19 BK nephropathy (23.8%). Other causes were fungal (N=15, 19%), parasitic (N=6, 7.5%) and bacterial (N=5, 6%). Most of OI occurred more than one year after transplant (N=47, 59% – 12.5 (5.7-30) months). Recipients with IO were significantly older (P=0.006) and with extended criteria donors (ECD) (P<0.0001). However, induction and maintenance immunosuppressive therapy was similar. ECD was an independant risk factor of OI (OR 3.26; P < 0.0001) while lymphocytes count at the time of transplant was protective (OR 0.56; P=0.014).
Kaplan Meier analysis showed that patient (P=0.001) and allograft survival (P=0.001) after OI were significantly lower. OI was an independent risk factor of kidney allograft survival [Table 1], but not an independent risk factor of patient survival.
|HR (CI 95%)||p-value|
|CD4 T-cells before transplant||0.25 (0.09-0.72)||0.010|
|Donor age||1.02 (1.01-1.04)||0.009|
|Donor CMV+||1.7 (1-2.89)||0.049|
We showed that OI after kidney transplantation were mostly viral without impact of immunosuppressive therapy. OI was an independent risk factors of allograft loss.
CITATION INFORMATION: Attias P., Melica G., Audureau E., Boutboul D., De Castro N., Gallien S., Grimbert P., Matignon M. Opportunistic Infections after Kidney Transplantation Are Independent Risk Factor of Kidney Allograft Loss: A Retrospective Cohort Study Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Attias P, Melica G, Audureau E, Boutboul D, Castro NDe, Gallien S, Grimbert P, Matignon M. Opportunistic Infections after Kidney Transplantation Are Independent Risk Factor of Kidney Allograft Loss: A Retrospective Cohort Study [abstract]. https://atcmeetingabstracts.com/abstract/opportunistic-infections-after-kidney-transplantation-are-independent-risk-factor-of-kidney-allograft-loss-a-retrospective-cohort-study/. Accessed December 13, 2019.
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