Moises A Huaman1, Valery Vilchez2, Xiaonan Mei3, Daniel Davenport3, Roberto Gedaly3. 1. Division of Infectious Diseases, Department of Medicine, University of Kentucky College of Medicine, Lexington, KY, USA. 2. Department of Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. 3. Section of Transplant Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
Abstract
BACKGROUND: The effect of blood culture positive donor (BCPD) on delayed graft function (DGF) in kidney transplant recipients has not been well established. METHODS: We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor kidney transplantation in US between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. We used propensity scores for 1:1 matching of BCPD and non-BCPD cohorts. DGF, graft and patient survival at one yr were compared between cohorts using multivariable logistic and Cox regression models. DGF was defined as requiring dialysis within the first week post-transplant. RESULTS: There were 4126 (8.1%) recipients of BCPD during the study period. DGF was associated with BCPD (aOR; 1.15, 95% CI 1.07-1.24). This association was maintained in the propensity-score matched analysis (p < 0.01). No association was found between BCPD and graft survival (aHR; 1.01, 95% CI, 0.92-1.09) or patient survival (aHR; 0.92, 95% CI, 0.82-1.04). CONCLUSION: Blood culture positive donor was associated with DGF but did not impact graft or patient survival in deceased-donor kidney transplants. This suggests a transient negative effect of BCPD that does not appear to translate into a more persistent deleterious outcome.
BACKGROUND: The effect of blood culture positive donor (BCPD) on delayed graft function (DGF) in kidney transplant recipients has not been well established. METHODS: We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor kidney transplantation in US between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. We used propensity scores for 1:1 matching of BCPD and non-BCPD cohorts. DGF, graft and patient survival at one yr were compared between cohorts using multivariable logistic and Cox regression models. DGF was defined as requiring dialysis within the first week post-transplant. RESULTS: There were 4126 (8.1%) recipients of BCPD during the study period. DGF was associated with BCPD (aOR; 1.15, 95% CI 1.07-1.24). This association was maintained in the propensity-score matched analysis (p < 0.01). No association was found between BCPD and graft survival (aHR; 1.01, 95% CI, 0.92-1.09) or patient survival (aHR; 0.92, 95% CI, 0.82-1.04). CONCLUSION: Blood culture positive donor was associated with DGF but did not impact graft or patient survival in deceased-donor kidney transplants. This suggests a transient negative effect of BCPD that does not appear to translate into a more persistent deleterious outcome.
Authors: Moises A Huaman; Valery Vilchez; Xiaonan Mei; Malay B Shah; Michael F Daily; Jonathan Berger; Roberto Gedaly Journal: Transpl Int Date: 2016-12-28 Impact factor: 3.782
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