Infections following rejection therapies in kidney and liver transplant recipients
Introduction Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection...
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Published in | Transplant infectious disease Vol. 24; no. 6; pp. e13981 - n/a |
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Abstract | Introduction
Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection.
Methods
This is a retrospective chart review of all liver and kidney transplant recipients treated for rejection at our institution from 2014 to 2020. We collected information on episodes of acute rejection in the first year of transplant and infections within 6 months following rejection treatment.
Results
We identified 257 transplant patients treated for rejection. One hundred twelve (43.6%) developed infections, with a total of 226 infections. Urinary tracts infections were the most common, 72 (31.9%), followed by cytomegalovirus viremia in 37 (16.4%), bacteremia in 24 (10.6%), and BK virus in 14 (6.2%). Female sex (p = .047), elevated neutrophil count at rejection (p = .002), and increased number of rejection episodes (p = .022) were predictors of infection in kidney and simultaneous liver‐kidney recipients. No specific type of induction or rejection therapy was identified as a risk factor for infection, likely due to the prophylaxis protocols at our institution. Infection post rejection treatment was associated with higher graft loss (p = .021) and mortality (p = .031) in kidney transplant recipients.
Conclusions
Infections are common complications after treatment of SOT rejection. Female gender, higher neutrophil at time of rejection, and increased numbers of rejection episodes were predictors of infections after rejection in simultaneous liver‐kidney and kidney transplant patients. Infections were predictors of graft loss at 6 months and mortality at any point in follow‐up in kidney transplant patients. |
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AbstractList | INTRODUCTIONInfections are known complications of solid-organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection. METHODSThis is a retrospective chart review of all liver and kidney transplant recipients treated for rejection at our institution from 2014 to 2020. We collected information on episodes of acute rejection in the first year of transplant and infections within 6 months following rejection treatment. RESULTSWe identified 257 transplant patients treated for rejection. One hundred twelve (43.6%) developed infections, with a total of 226 infections. Urinary tracts infections were the most common, 72 (31.9%), followed by cytomegalovirus viremia in 37 (16.4%), bacteremia in 24 (10.6%), and BK virus in 14 (6.2%). Female sex (p = .047), elevated neutrophil count at rejection (p = .002), and increased number of rejection episodes (p = .022) were predictors of infection in kidney and simultaneous liver-kidney recipients. No specific type of induction or rejection therapy was identified as a risk factor for infection, likely due to the prophylaxis protocols at our institution. Infection post rejection treatment was associated with higher graft loss (p = .021) and mortality (p = .031) in kidney transplant recipients. CONCLUSIONSInfections are common complications after treatment of SOT rejection. Female gender, higher neutrophil at time of rejection, and increased numbers of rejection episodes were predictors of infections after rejection in simultaneous liver-kidney and kidney transplant patients. Infections were predictors of graft loss at 6 months and mortality at any point in follow-up in kidney transplant patients. Infections are known complications of solid-organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection. This is a retrospective chart review of all liver and kidney transplant recipients treated for rejection at our institution from 2014 to 2020. We collected information on episodes of acute rejection in the first year of transplant and infections within 6 months following rejection treatment. We identified 257 transplant patients treated for rejection. One hundred twelve (43.6%) developed infections, with a total of 226 infections. Urinary tracts infections were the most common, 72 (31.9%), followed by cytomegalovirus viremia in 37 (16.4%), bacteremia in 24 (10.6%), and BK virus in 14 (6.2%). Female sex (p = .047), elevated neutrophil count at rejection (p = .002), and increased number of rejection episodes (p = .022) were predictors of infection in kidney and simultaneous liver-kidney recipients. No specific type of induction or rejection therapy was identified as a risk factor for infection, likely due to the prophylaxis protocols at our institution. Infection post rejection treatment was associated with higher graft loss (p = .021) and mortality (p = .031) in kidney transplant recipients. Infections are common complications after treatment of SOT rejection. Female gender, higher neutrophil at time of rejection, and increased numbers of rejection episodes were predictors of infections after rejection in simultaneous liver-kidney and kidney transplant patients. Infections were predictors of graft loss at 6 months and mortality at any point in follow-up in kidney transplant patients. Abstract Introduction Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection. Methods This is a retrospective chart review of all liver and kidney transplant recipients treated for rejection at our institution from 2014 to 2020. We collected information on episodes of acute rejection in the first year of transplant and infections within 6 months following rejection treatment. Results We identified 257 transplant patients treated for rejection. One hundred twelve (43.6%) developed infections, with a total of 226 infections. Urinary tracts infections were the most common, 72 (31.9%), followed by cytomegalovirus viremia in 37 (16.4%), bacteremia in 24 (10.6%), and BK virus in 14 (6.2%). Female sex ( p = .047), elevated neutrophil count at rejection ( p = .002), and increased number of rejection episodes ( p = .022) were predictors of infection in kidney and simultaneous liver‐kidney recipients. No specific type of induction or rejection therapy was identified as a risk factor for infection, likely due to the prophylaxis protocols at our institution. Infection post rejection treatment was associated with higher graft loss ( p = .021) and mortality ( p = .031) in kidney transplant recipients. Conclusions Infections are common complications after treatment of SOT rejection. Female gender, higher neutrophil at time of rejection, and increased numbers of rejection episodes were predictors of infections after rejection in simultaneous liver‐kidney and kidney transplant patients. Infections were predictors of graft loss at 6 months and mortality at any point in follow‐up in kidney transplant patients. image Introduction Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection. Methods This is a retrospective chart review of all liver and kidney transplant recipients treated for rejection at our institution from 2014 to 2020. We collected information on episodes of acute rejection in the first year of transplant and infections within 6 months following rejection treatment. Results We identified 257 transplant patients treated for rejection. One hundred twelve (43.6%) developed infections, with a total of 226 infections. Urinary tracts infections were the most common, 72 (31.9%), followed by cytomegalovirus viremia in 37 (16.4%), bacteremia in 24 (10.6%), and BK virus in 14 (6.2%). Female sex (p = .047), elevated neutrophil count at rejection (p = .002), and increased number of rejection episodes (p = .022) were predictors of infection in kidney and simultaneous liver‐kidney recipients. No specific type of induction or rejection therapy was identified as a risk factor for infection, likely due to the prophylaxis protocols at our institution. Infection post rejection treatment was associated with higher graft loss (p = .021) and mortality (p = .031) in kidney transplant recipients. Conclusions Infections are common complications after treatment of SOT rejection. Female gender, higher neutrophil at time of rejection, and increased numbers of rejection episodes were predictors of infections after rejection in simultaneous liver‐kidney and kidney transplant patients. Infections were predictors of graft loss at 6 months and mortality at any point in follow‐up in kidney transplant patients. |
Author | Chascsa, David M. H. Vikram, Holenarasipur R. Me, Hay‐Me Budhiraja, Pooja Joseph, Anna M. Kodali, Lavanya Zhang, Nan Yaman, Reena N. Gupta, Simran Gea‐Banacloche, Juan Heilman, Raymond L. |
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Keywords | infections kidney transplant opportunistic infections acute rejection liver transplant solid organ transplant |
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References_xml | – volume: 13 start-page: 3 issue: 4 year: 2013 end-page: 8 article-title: Introduction: infections in solid organ transplantation publication-title: Am J Transplant – volume: 17 start-page: 286 issue: 2 year: 2022 end-page: 295 article-title: Long‐term infectious complications of kidney transplantation publication-title: Clin J Am Soc Nephrol – volume: 24 start-page: 273 issue: 2 year: 2010 end-page: 283 article-title: Infection in organ transplantation: risk factors and evolving patterns of infection publication-title: Infect Dis Clin North Am – volume: 16 issue: 4 year: 2021 article-title: Infectious complications and graft outcome following treatment of acute antibody‐mediated rejection after kidney transplantation: a nationwide cohort study publication-title: PLoS One – volume: 20 start-page: 519 year: 2020 article-title: Epidemiology, risk factors, and clinical impact of early post‐transplant infection in older kidney transplant recipients: the Korean organ transplantation registry study publication-title: BMC Geriatr. – volume: 33 start-page: 1143 issue: 4 year: 2019 end-page: 1157 article-title: Opportunistic infections in transplant patients publication-title: Infect Dis Clin North Am – volume: 5 year: 2018 article-title: Incidence rate of post‐kidney transplant infection: a retrospective cohort study examining infection rates at a large Canadian Multicenter Tertiary‐Care Facility publication-title: Can J Kidney Health Dis – volume: 71 start-page: e159 year: 2020 end-page: e169 article-title: Burden and timeline of infectious diseases in the first year after solid‐organ transplantation publication-title: Clin Infect Dis – volume: 357 start-page: 2601 issue: 25 year: 2007 end-page: 2614 article-title: Infection in solid‐organ transplant recipients publication-title: N Engl J Med – volume: 15 start-page: 197 issue: 4 year: 2019 end-page: 206 article-title: Definition of opportunistic infections in immunocompromised children on the basis of etiologies and clinical features: a summary for practical purposes publication-title: Curr Pediatr Rev – volume: 21 start-page: 198 issue: 1 year: 2021 end-page: 207 article-title: Characterizing the landscape and impact of infections following kidney transplantation publication-title: Am J Transplant – ident: e_1_2_9_10_1 doi: 10.1371/journal.pone.0250829 – ident: e_1_2_9_11_1 doi: 10.2174/1573396315666190617151745 – ident: e_1_2_9_8_1 doi: 10.1177/2054358118799692 – ident: e_1_2_9_6_1 doi: 10.1016/j.idc.2010.01.005 – ident: e_1_2_9_2_1 doi: 10.1111/ajt.12093 – ident: e_1_2_9_5_1 doi: 10.1186/s12877-020-01859-3 – ident: e_1_2_9_4_1 doi: 10.1111/ajt.16106 – ident: e_1_2_9_3_1 doi: 10.2215/CJN.15971020 – ident: e_1_2_9_7_1 doi: 10.1016/j.idc.2019.05.008 – ident: e_1_2_9_9_1 doi: 10.1093/cid/ciz1113 – ident: e_1_2_9_12_1 doi: 10.1056/NEJMra064928 |
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Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency... Infections are known complications of solid-organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection... Abstract Introduction Infections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study... IntroductionInfections are known complications of solid‐organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency... INTRODUCTIONInfections are known complications of solid-organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency... |
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SubjectTerms | acute rejection Bacteremia Complications Cytomegalovirus Female Females Gender Graft rejection Graft Rejection - drug therapy Graft Rejection - prevention & control Health risks Humans Immunosuppressive Agents - therapeutic use Infections Kidney kidney transplant Kidney transplantation Kidney transplants Kidneys Leukocytes (neutrophilic) Liver liver transplant Liver transplantation Liver Transplantation - adverse effects Liver transplants Mortality Neutrophils opportunistic infections Organ Transplantation - adverse effects Prophylaxis Rejection Retrospective Studies Risk analysis Risk factors solid organ transplant Transplant Recipients Viremia Viruses |
Title | Infections following rejection therapies in kidney and liver transplant recipients |
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