Session Name: Concurrent Session: Infectious Epidemiology
Session Type: Concurrent Session
Date: Monday, June 3, 2019
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: Room 304
*Purpose: Solid organ transplantation is being increasingly offered to older patients with concurrent chronic medical conditions such as cardiovascular, cerebrovascular, and renal disease. Risk of death from infection has been shown to increase exponentially with age among kidney transplant recipients. Similarly, infection was the leading primary and contributory cause of death in older liver transplant (LT) recipients (age >65). Our study aims to describe the clinical outcomes of older adults after an infection occurring within the 200 days of LT in contrast to younger adults.
*Methods: This is a multi-center retrospective study of adult (age >18) primary LT recipients between 2013-2016; dual organ transplants were excluded. Data obtained by chart review were the following: demographics, co-morbidities, transplant data, post-transplant infections within 200 days of LT, and status at 30-days post-infection. Patients were stratified into 3 age groups: 18-49, 50-64 and >65. Differences on patient demographic, clinical, and transplant characteristics between age categories were conducted using ANOVA for continuous variables. Chi-square or fisher’s exact test was performed for categorical variables and differences on desired outcomes (i.e. rate of infections and 30-day mortality). All analyses were conducted using SAS version 9.4.
*Results: 570 LT recipients met criteria. Differences among age groups 18-49, 50-64 and >65 were found in the following baseline characteristics: diabetes (7.9% vs 44.7% vs. 7.4%, p<0.0001), alcohol-related cirrhosis (26.9% vs 3.0% vs 10.2%, p=0.0203), hepatitis C (7.9% vs. 81.5% vs. 10.77%, p<0.0001), fatty liver (11.2% vs 54.2% vs 34.6%, p<0.0001), hepatocellular carcinoma (2.8% vs 74.4% vs 22.88%, p<0.0001), and cryptogenic/idiopathic (14.3% vs 51.4% vs 34.3%, p<0.0154). A total of 259/570 (45%) LT recipients developed >1 infection within 200 days of LT and rates of infection in the 18-49, 50-64 and >65 were: 48% (52/108) of 18-49, 55% (200/367) of 50-64, and 62% (59/95). Bacterial infections were predominant (56%). The 30-day mortality after an infection was not significantly different across the age groups [6 (54.6%) vs 4 (36.4%) vs 1 (9.1%), p= 0.1568].
*Conclusions: Rates of infection did not differ across age groups in this cohort; nor was there any increased 30-day mortality with age. Further analysis of the significant variables noted may elucidate differences among these groups.
To cite this abstract in AMA style:Garcia-Diaz J, Kerkelis M, Shah T, Tucker M, Gastanaduy M, Woo J, Ponder M, Malinis M, Malinis M. The Outcomes after an Infection in Older Liver Transplant Recipients is Comparable to Younger Adults [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-outcomes-after-an-infection-in-older-liver-transplant-recipients-is-comparable-to-younger-adults/. Accessed June 28, 2022.
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