Abstract
Background: Respiratory tract infections (RTIs) are a leading cause of death after kidney transplant. Preventive strategies may be implemented during a dedicated infectious disease consultation (IDC) before transplantation. Impact of IDC on RTIs after transplant has not been determined. Methods: We conducted a monocentric retrospective cohort analysis including all kidney transplant recipients from January 2015 to December 2019. We evaluated the impact of IDC on RTIs and identified risk and protective factors associated with RTIs. Results: We included 516 kidney transplant recipients. Among these, 145 had an IDC before transplant. Ninety-five patients presented 123 RTIs, including 75 (61%) with pneumonia. Patient that benefited from IDC presented significantly less RTIs (p = 0.049). RTIs were an independent risk factor of mortality (HR = 3.64 (1.97–6.73)). Independent risk factors for RTIs included HIV (OR = 3.33 (1.43–7.74)) and HCV (OR = 3.76 (1.58–8.96)). IDC was identified as an independent protective factor (OR = 0.48 (0.26–0.88)). IDC prior to transplantation is associated with diminished RTIs and is an independent protective factor. RTIs after kidney transplant are an independent risk factor of death. Implementing systematic IDC may have an important impact on reducing RTIs and related morbidity and mortality.
Subject
Infectious Diseases,Microbiology (medical),General Immunology and Microbiology,Molecular Biology,Immunology and Allergy
Reference50 articles.
1. WHO (2021, March 28). WHO | GKT1 Activity and Practices. Available online: https://www.who.int/transplantation/gkt/statistics/en/.
2. Infectious complications associated with immunomodulating biologic agents;Koo;Infect. Dis. Clin. N. Am.,2010
3. Infection in solid-organ transplant recipients;Fishman;N. Engl. J. Med.,2007
4. Secular Trends in Infection-Related Mortality after Kidney Transplantation;Kinnunen;CJASN,2018
5. OPTN/SRTR 2019 Annual Data Report: Kidney;Hart;Am. J. Transplant.,2021