Significance of immediate preoperative bacteriuria with pyuria in renal transplant recipients

• Published in: The Journal of urology Vol. 137; no. 4; p. 633
• Main Authors: Hatch, D A, Barry, J M
• Format: Journal Article
• Language: English
• Published: United States 01.04.1987
• Subjects: Adult; Bacteriuria - complications; Female; Humans; Kidney Transplantation; Male; Middle Aged; Pyuria - complications; Surgical Wound Infection - etiology
• ISSN: 0022-5347
• DOI: 10.1016/S0022-5347(17)44160-7

The presence of bacteriuria and pyuria on urinalysis immediately before renal transplantation has resulted in cancellation of surgery because of concern about post-transplant wound infection. Of 113 renal transplant recipients reviewed 41 (36 per cent) had 5 or more white blood cells per high power field with bacteria in either a voided urine or bladder washout specimen obtained just before grafting. Of those 41 patients 2 suffered postoperative wound infections. Of 72 patients (64 per cent) with less than 5 white blood cells or no bacteria on a preoperative specimen 1 suffered a wound infection (p not significant by Fisher's exact test). Preoperative urine cultures and operative bladder cultures of all 3 patients failed to yield the organisms found later in the wound infections. The factors of sex, insulin-dependent diabetes, delayed graft function, living related versus cadaver donor and pre-transplant splenectomy had no significant relationship to wound infection rates. Renal transplantation can be performed safely in patients who have pyuria and bacteriuria but no signs or symptoms of infection.