OBJECTIVES: To evaluate outcomes in renal transplant recipients who received organs from donors with positive blood or urine cultures.

METHODS: We performed a retrospective, single-center study of transplant recipients aged >18 years who received a kidney from a deceased donor with positive urine and/or blood cultures between 1/1/2014 and 12/31/2016. Pediatric-en-bloc kidney recipients were excluded. Outcomes of interest included infections, readmissions, and graft and patient survival within 90 days of transplantation.

RESULTS: Overall, 163 recipients received kidneys from 123 donors with positive blood (n=48) and/or urine (n=88) cultures. The most common donor blood organisms were coagulase-negative staphylococci (47.9%). Common urine organisms were Escherichia coli (19.3%), yeast (19.3%), enterococci (15.9%) and coagulase-negative staphylococci (13.6%). Kidney recipients received antimicrobials for an average of 12 days for positive donor blood cultures (n=35), 25 days for positive donor urine cultures (n=82), and 22 days when blood and urine cultures were both positive (n=16). Thirty-three recipients did not receive any antimicrobials. Five (3%) recipients developed bacteremia within 90 days post-transplantation; one involved the same organism as the donor culture. Thirty (18.4%) recipients developed bacteriuria within 90 days post-transplantation; one involved the same organism as the donor culture. Clostridium difficile infection occurred in 4 (2%) recipients within 90 days of transplantation. Fifty-two (32%) recipients were re-admitted at least once within 90 days of transplantation; 18 readmissions were infection-related. At 90 days post-transplantation, 3 (1.8%) grafts had failed and no recipients had died.

CONCLUSIONS: The rate of donor to recipient infection transmission is very low. We also found low rates of infectious and graft complications after transplantation in this cohort. Use of kidneys from donors with positive blood or urine cultures is generally safe.

CITATION INFORMATION: Chen L., Kamiyama D., Francalacci L., Zhu E., Donnelley M., Clayton N., Alman K., De Mattos A., Brown J. Outcomes of Renal Transplants from Donors with Positive Blood or Urine Cultures Am J Transplant. 2017;17 (suppl 3).

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