Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
INTRODUCTION: Candida cultured in transplant perfusion fluid (TPF) may have adverse consequences (Mai 2006). TPF culture rates, frequency of positive culture results and associated clinical outcomes were audited.
METHOD: Retrospective analysis of prospective data from Jan 2013June 2014. Culture results of paired organs transplanted elsewhere were obtained via NHSBT
RESULTS: 198/259 (76%) deceased donor transplants had TPF sent for culture.
36/198 (18%) samples were culture positive at 48 hours. Positive bacteria culture rates were similar in DD KT and SPK. Candida culture was 5 times more frequent in SPK compared to DD KT. All Candida culture positive patients received additional anti-fungal therapy and had no direct adverse outcomes. Regarding 29 bacteria positive TPF; 17/29 (59%) patients received extra antibiotics: 2 patients for concurrent chest infection that covered TPF results; 3 patients at re-exploration early post-transplant for unrelated reasons; and 12 patients based only on TPF result and sensitivity. Of these, 11/12 were successfully treated but one DD KT with E. coli in TPF required nephrectomy on day 12 for infection after multiple cultures of the same organism. 4 DD KT and 1 SPK did not receive extra antibiotic after consultant review. Documentation was less clear in 7 patients but all had good outcome. Regarding paired organs with positive TPF: at our unit 9 single organ pairs had 5 concordant positive TPF results; 4 were discordant. The 16 other pair kidneys went to 11 UK units (2 for research): 7 units (receiving 10 kidneys) do not routinely culture TPF; 3 units (receiving 4 kidneys) culture TPF, of which, 3 were culture positive.
CONCLUSION: TPF positive cultures were common, with Candida more frequent in SPK than DD KT. Treatment of positive TPF cultures led to good clinical outcomes. We recommend routine TPF culture until a RCT advises otherwise. Communication of positive TPF culture results between UK units may be advised.
To cite this abstract in AMA style:Taylor C, Tabbakh Y, Yershov D, Calder F, Callaghan C, Drage M, Karydis N, Kessaris N, Loukopoulos I, Mamode N, Olsburgh J. Transport Perfusion Fluid Analysis from Deceased Donor Kidney Transplants (DD KT) and Pancreas Transplants (SPK; PAK; PTA) [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/transport-perfusion-fluid-analysis-from-deceased-donor-kidney-transplants-dd-kt-and-pancreas-transplants-spk-pak-pta/. Accessed April 20, 2021.
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