Mp70-19 does Early Withdrawal of Urinary Catheter Following Kidney Transplant Reduce Urinary Tract Infections (Uti)?

Abstract

Data tables were generated from the OHSU transplant Datamart, which contains key data elements for each OHSU kidney transplant. Additional data elements were integrated from the UNOS's Review of Organ offers report which provides additional data about the organ donor and non-identifiable outcomes of other transplants from the same donor. The incidence of DGF was calculated; univariate and multivariate analysis were performed on recipient, donor, and other variables. Chart review was performed on cases with DGF to identify possible recipient causes.RESULTS: Between 1/1/2012-12/31/2016, 326 patients received deceased donor kidney transplants at OHSU. The overall number of DGF was 31 (9.5%). The rate of DGF decreased from 20.8% in 2012 to 2.7% in 2016. Univariate analysis revealed that male sex, donation after circulatory death (DCD), DGF in the mate kidney, increased donor age, higher KDPI, cold ischemia time, and earlier transplant year were associated with increased risk of DGF. On multivariate analysis, DCD, KDPI, DGF in the mate kidney, cold ischemia time >15hrs, pulsatile perfusion were associated with increased risk of DGF. In the 31 patients that had DGF, recipient causes such as myocardial infarction, severe perioperative hypotension, cardiac arrhythmia, simultaneous heart transplant, vascular complications, rejection, and recurrence of disease accounted for 11 of the 31 (35%) patients with DGF.CONCLUSIONS: Rates of DGF in deceased donor kidney transplant at OHSU are lower than rates that are commonly reported. This may suggest that DGF rates may be modifiable through relatively simple interventions such as use of pulsatile perfusion or protocolled procurement. Recipient factors, especially cardiovascular hemodynamic status, may be responsible for DGF in about 3% of all transplants which may be represent an additional area for research and quality improvement.

A Nurse-Driven Protocol for Foley Catheter Utilization Decreases the Incidence of Traumatic Foley Catheterization

“…Because of the focus on the risk of catheter-associated urinary tract infections (CAUTI) and on methods to reduce the incidence of this complication, 11 - 13 many hospitals have implemented protocols to limit Foley catheterization days with the goal of decreasing CAUTI rates. 14 , 15 …”