In:
Open Forum Infectious Diseases, Oxford University Press (OUP)
Abstract:
Infectious diseases (ID) are highly relevant after solid organ transplantation in terms of morbidity and mortality, being among the most common causes of death. Patients undergoing kidney re-transplantation (re-K-Tx) have been already receiving immunosuppressive therapy over a prolonged period potentially facilitating subsequent infections. Comparing ID events after re-K-Tx and first kidney transplantation (f-K-Tx) can delineate patterns and risks of ID events associated with prolonged immunosuppression. Methods We included adult patients with records on the f-K-Tx and re-K-Tx in the Swiss Transplant Cohort Study. We analyzed ID events after f-K-Tx and re-K-Tx within the same patients, and compared infection rates, causative pathogens and infection sites. Recurrent time to event analyses were performed for comparison of infection rates. Results A total of 59 patients with a median age of 47 years (range = 18 - 73) were included. Overall, 312 ID events in 52 patients occurred. In multivariable recurrent event modelling, the rate of ID events was significantly lower after re-K-Tx (HR = 0.70, p = 0.02). More bacterial (68.9% versus 60.4%) and fungal (4.0% versus 1.1%) infections were observed after f-K-Tx, but less viral infections (27.0% versus 38.5%) as compared to after re-K-Tx (p = 0.11). After f-K-Tx, urinary tract and gastrointestinal tract infections were more frequent; after re-K-Tx, respiratory tract and surgical site infections were more frequent (p & lt; 0.001). Conclusions Infectious disease events were less frequent after re-K-Tx. Affected sites differed significantly after f-K-Tx compared to after re-K-Tx.
Type of Medium:
Online Resource
ISSN:
2328-8957
DOI:
10.1093/ofid/ofae055
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2024
detail.hit.zdb_id:
2757767-3
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