Surgical site infections after kidney transplantation are independently associated with graft loss

Schreiber, Peter W.; Hoessly, Linard D.; Boggian, Katia; Neofytos, Dionysios; van Delden, Christian; Egli, Adrian; Dickenmann, Michael; Hirzel, Cédric; Manuel, Oriol; Koller, Michael; Rossi, Simona; Banz, Vanessa; Schmied, Bruno; Guerke, Lorenz; Matter, Maurice; de Rougemont, Olivier; Bonani, Marco; Golshayan, Déla; Schnyder, Aurelia; Sidler, Daniel; Haidar, Fadi; Kuster, Stefan P.; Stampf, Susanne; Mueller, Nicolas J.; Amico, Patrizia; Aubert, John-David; Banz, Vanessa; Beckmann, Sonja; Beldi, Guido; Berger, Christoph; Berishvili, Ekaterine; Berzigotti, Annalisa; Binet, Isabelle; Bochud, Pierre-Yves; Branca, Sanda; Bucher, Heiner; Catana, Emmanuelle; Cairoli, Anne; Chalandon, Yves; De Geest, Sabina; De Rougemont, Olivier; De Seigneux, Sophie; Dickenmann, Michael; Dreifuss, Joëlle Lynn; Duchosal, Michel; Fehr, Thomas; Ferrari-Lacraz, Sylvie; Garzoni, Christian; Golshayan, Déla; Goossens, Nicolas; Haidar, Fadi; Halter, Jörg; Heim, Dominik; Hess, Christoph; Hillinger, Sven; Hirsch, Hans H.; Hirt, Patricia; Hoessly, Linard; Hofbauer, Günther; Huynh-Do, Uyen; Immer, Franz; Koller, Michael; Laesser, Bettina; Lamoth, Frédéric; Lehmann, Roger; Leichtle, Alexander; Manuel, Oriol; Marti, Hans-Peter; Martinelli, Michele; McLin, Valérie; Mellac, Katell; Merçay, Aurélia; Mettler, Karin; Mueller, Nicolas J.; Müller-Arndt, Ulrike; Müllhaupt, Beat; Nägeli, Mirjam; Oldani, Graziano; Pascual, Manuel; Passweg, Jakob; Pazeller, Rosemarie; Posfay-Barbe, Klara; Rick, Juliane; Rosselet, Anne; Rossi, Simona; Rothlin, Silvia; Ruschitzka, Frank; Schachtner, Thomas; Schaub, Stefan; Scherrer, Alexandra; Schnyder, Aurelia; Schuurmans, Macé; Schwab, Simon; Sengstag, Thierry; Simonetta, Federico; Stampf, Susanne; Steiger, Jürg; Stirnimann, Guido; Stürzinger, Ueli; Van Delden, Christian; Venetz, Jean-Pierre; Villard, Jean; Vionnet, Julien; Wick, Madeleine; Wilhelm, Markus; Yerly, Patrick

doi:10.1016/j.ajt.2023.11.013

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Few studies determined overall postoperative complications (POC) as their primary endpoint. Most studies targeted specific adverse outcomes after KT, such as mortality, graft survival, delayed graft function (DGF) or infectious complications 4 – 7 . Likewise, studies investigating the value of markers like lab tests to predict adverse outcomes are scant.…”

Section: Introductionmentioning

confidence: 99%

Assessing the perioperative gain of weight (Δweight) as a determinant of morbidity after kidney transplantation: a retrospective exploratory study

Carbonell,

Zingg,

Matter

et al. 2024

Sci Rep

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Kidney transplantation (KT) is associated with a substantial risk of postoperative complications (POC) for which performant predictors are lacking. Data showed that a perioperative gain of weight (ΔWeight) was associated with higher risk of POC, but it remains unexplored in KT. This retrospective study aimed to investigate the association between ΔWeight and POC after KT. ΔWeight was calculated on postoperative day (POD) 2. POC were graded according to the Dindo-Clavien classification. Primary endpoint was overall POC. A total of 242 patients were included and 174 (71.9%) complications were reported. Patients showed a rapid gain of weight after KT. Mean ΔWeight was 7.83 kg (± 3.20) compared to 5.3 kg (± 3.56) in patients with and without complication, respectively (p = 0.0005). ΔWeight showed an accuracy of 0.74 for overall POC. A cut-off of 8.5 kg was determined. ΔWeight ≥ 8.5 kg was identified as an independent predictor of overall POC on multivariable analysis (OR 2.04; 95% CI 1.08–3.84; p = 0.025). ΔWeight ≥ 8.5 kg appeared as an independent predictor of POC after KT. These results stress the need to monitor weight in KT and to further investigate this surrogate with future studies assessing its clinical relevance.

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Section: Introductionmentioning

confidence: 99%

Assessing the perioperative gain of weight (Δweight) as a determinant of morbidity after kidney transplantation: a retrospective exploratory study

Carbonell,

Zingg,

Matter

et al. 2024

Sci Rep

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Do Infectious Diseases After Kidney Retransplantation Differ From Those After First Kidney Transplantation?

Kusejko,

Neofytos,

van Delden

et al. 2024

Open Forum Infectious Diseases

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Background 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 < 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.

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Renal Transplant Anastomotic Pseudoaneurysm and Stenosis at the Proximal Transplant Renal Artery and Worse Renal Blood Flow After Stent Placement

Wang,

Li,

2024

Clin Nucl Med

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A 60-year-old man with a history of end-stage renal disease received renal transplant and had decreasing renal function 4 months later. Nuclear medicine renal flow and functional study showed severely decreased blood flow and decreased function of the right renal allograft. There was focal increased radiotracer uptake at blood flow phase around the anastomosis of the renal allograft artery and the right external iliac artery. CT angiogram revealed right external iliac artery pseudoaneurysm. Interventional radiology angiography reconfirmed the pseudoaneurysm and revealed stenosis at the proximal transplant renal artery. After stent placement, however, there was worse renal allograft blood flow.

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Surgical site infections after kidney transplantation are independently associated with graft loss

Cited by 3 publications

References 29 publications

Assessing the perioperative gain of weight (Δweight) as a determinant of morbidity after kidney transplantation: a retrospective exploratory study

Assessing the perioperative gain of weight (Δweight) as a determinant of morbidity after kidney transplantation: a retrospective exploratory study

Do Infectious Diseases After Kidney Retransplantation Differ From Those After First Kidney Transplantation?

Renal Transplant Anastomotic Pseudoaneurysm and Stenosis at the Proximal Transplant Renal Artery and Worse Renal Blood Flow After Stent Placement

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