Skip to main content
Top
Published in: European Journal of Clinical Microbiology & Infectious Diseases 1/2019

01-01-2019 | Original Article

Single-center analysis of infectious complications in older adults during the first year after kidney transplantation

Authors: Marion Hemmersbach-Miller, Barbara D. Alexander, Debra L. Sudan, Carl Pieper, Kenneth E. Schmader

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 1/2019

Login to get access

Abstract

Infections are among the top three causes of death of older adults in the first year after kidney transplantation (KT). Our aim was to describe infectious complications among KT recipients aged ≥ 65 during the first 12 months post-transplant. Single-center retrospective cohort study. Ninety-one KTs had been performed in patients ≥ 65 years of age between 2011 and 2015. 92.3% of the patients developed at least one infection. Infectious episodes increased the risk of future infection by 10% (p = 0.0018) with each infection portending a greater risk. At a patient level, viral (71.4%) and bacterial (70.2%) infections predominated. Urinary tract infections were the most frequent complication (30.3%), followed by cytomegalovirus infections (22.7%). Infections were the main reason for readmission. 7.7% of the patients developed rejection; and overall 3.3% lost their graft. Mortality at 1 year was 9.9%. Older KT recipients have a high incidence of infectious complications the first year after KT. Infections were the number one reason for readmission, and an infection episode predicted future infections for the individual patient. Despite these complications, the majority of older KT recipients were alive with a functioning graft at 1 year.
Literature
4.
go back to reference Saran R, Li Y, Robinson B, Ayanian J, Balkrishnan R, Bragg-Gresham J, Chen JT, Cope E, Gipson D, He K, Herman W, Heung M, Hirth RA, Jacobsen SS, Kalantar-Zadeh K, Kovesdy CP, Leichtman AB, Lu Y, Molnar MZ, Morgenstern H, Nallamothu B, O'Hare AM, Pisoni R, Plattner B, Port FK, Rao P, Rhee CM, Schaubel DE, Selewski DT, Shahinian V, Sim JJ, Song P, Streja E, Kurella Tamura M, Tentori F, Eggers PW, Agodoa LY, Abbott KC (2015) US renal data system 2014 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 66(1 Suppl 1):Svii):S1–S305. https://doi.org/10.1053/j.ajkd.2015.05.001 CrossRef Saran R, Li Y, Robinson B, Ayanian J, Balkrishnan R, Bragg-Gresham J, Chen JT, Cope E, Gipson D, He K, Herman W, Heung M, Hirth RA, Jacobsen SS, Kalantar-Zadeh K, Kovesdy CP, Leichtman AB, Lu Y, Molnar MZ, Morgenstern H, Nallamothu B, O'Hare AM, Pisoni R, Plattner B, Port FK, Rao P, Rhee CM, Schaubel DE, Selewski DT, Shahinian V, Sim JJ, Song P, Streja E, Kurella Tamura M, Tentori F, Eggers PW, Agodoa LY, Abbott KC (2015) US renal data system 2014 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 66(1 Suppl 1):Svii):S1–S305. https://​doi.​org/​10.​1053/​j.​ajkd.​2015.​05.​001 CrossRef
9.
go back to reference Trouillhet I, Benito N, Cervera C, Rivas P, Cofan F, Almela M, Angeles Marcos M, Puig de la Bellacasa J, Pumarola T, Oppenheimer F, Moreno-Camacho A (2005) Influence of age in renal transplant infections: cases and controls study. Transplantation 80(7):989–992CrossRefPubMed Trouillhet I, Benito N, Cervera C, Rivas P, Cofan F, Almela M, Angeles Marcos M, Puig de la Bellacasa J, Pumarola T, Oppenheimer F, Moreno-Camacho A (2005) Influence of age in renal transplant infections: cases and controls study. Transplantation 80(7):989–992CrossRefPubMed
10.
12.
go back to reference Ljungman P, Boeckh M, Hirsch HH, Josephson F, Lundgren J, Nichols G, Pikis A, Razonable RR, Miller V, Griffiths PD (2016) Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. https://doi.org/10.1093/cid/ciw668 Ljungman P, Boeckh M, Hirsch HH, Josephson F, Lundgren J, Nichols G, Pikis A, Razonable RR, Miller V, Griffiths PD (2016) Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. https://​doi.​org/​10.​1093/​cid/​ciw668
20.
go back to reference Meier-Kriesche H, Ojo AO, Arndorfer JA, Leichtman AB, Lake K, Cibrik DM, Punch JD, Armstrong DR, Kaplan B (2001) Need for individualized immunosuppression in elderly renal transplant recipients. Transplant Proc 33(1–2):1190–1191CrossRefPubMed Meier-Kriesche H, Ojo AO, Arndorfer JA, Leichtman AB, Lake K, Cibrik DM, Punch JD, Armstrong DR, Kaplan B (2001) Need for individualized immunosuppression in elderly renal transplant recipients. Transplant Proc 33(1–2):1190–1191CrossRefPubMed
21.
go back to reference Mandelbrot DA, Fleishman A, Rodrigue JR, Norman SP, Samaniego M (2017) Practices in the evaluation of potential kidney transplant recipients who are elderly: a survey of U.S. transplant centers. Clin Transpl 31(10). https://doi.org/10.1111/ctr.13088 Mandelbrot DA, Fleishman A, Rodrigue JR, Norman SP, Samaniego M (2017) Practices in the evaluation of potential kidney transplant recipients who are elderly: a survey of U.S. transplant centers. Clin Transpl 31(10). https://​doi.​org/​10.​1111/​ctr.​13088
24.
go back to reference Hernandez D, Alonso-Titos J, Armas-Padron AM, Ruiz-Esteban P, Cabello M, Lopez V, Fuentes L, Jironda C, Ros S, Jimenez T, Gutierrez E, Sola E, Frutos MA, Gonzalez-Molina M, Torres A (2018) Mortality in elderly waiting-list patients versus age-matched kidney transplant recipients: where is the risk? Kidney Blood Press Res 43(1):256–275. https://doi.org/10.1159/000487684 CrossRefPubMed Hernandez D, Alonso-Titos J, Armas-Padron AM, Ruiz-Esteban P, Cabello M, Lopez V, Fuentes L, Jironda C, Ros S, Jimenez T, Gutierrez E, Sola E, Frutos MA, Gonzalez-Molina M, Torres A (2018) Mortality in elderly waiting-list patients versus age-matched kidney transplant recipients: where is the risk? Kidney Blood Press Res 43(1):256–275. https://​doi.​org/​10.​1159/​000487684 CrossRefPubMed
25.
go back to reference Legeai C, Andrianasolo RM, Moranne O, Snanoudj R, Hourmant M, Bauwens M, Soares J, Jacquelinet C, Couchoud C, Macher MA (2018) Benefits of kidney transplantation for a national cohort of patients aged 70 years and older starting renal replacement therapy. Am J Transplant. https://doi.org/10.1111/ajt.15110 Legeai C, Andrianasolo RM, Moranne O, Snanoudj R, Hourmant M, Bauwens M, Soares J, Jacquelinet C, Couchoud C, Macher MA (2018) Benefits of kidney transplantation for a national cohort of patients aged 70 years and older starting renal replacement therapy. Am J Transplant. https://​doi.​org/​10.​1111/​ajt.​15110
33.
go back to reference Ooms L, IJ J, Voor In 't Holt A, Betjes M, Vos M, Terkivatan T (2017) Urinary Tract Infections After Kidney Transplantation: A Risk Factor Analysis of 417 Patients. Ann Transplant 22:402–408CrossRefPubMed Ooms L, IJ J, Voor In 't Holt A, Betjes M, Vos M, Terkivatan T (2017) Urinary Tract Infections After Kidney Transplantation: A Risk Factor Analysis of 417 Patients. Ann Transplant 22:402–408CrossRefPubMed
Metadata
Title
Single-center analysis of infectious complications in older adults during the first year after kidney transplantation
Authors
Marion Hemmersbach-Miller
Barbara D. Alexander
Debra L. Sudan
Carl Pieper
Kenneth E. Schmader
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 1/2019
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-018-3405-5

Other articles of this Issue 1/2019

European Journal of Clinical Microbiology & Infectious Diseases 1/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.