Infections and severe sepsis in solid-organ transplant patients admitted from a university-based ED

Am J Emerg Med. 2004 Nov;22(7):530-3. doi: 10.1016/j.ajem.2004.09.010.


The objective was to provide a descriptive analysis of infectious processes in transplant patients admitted from the emergency department (ED). A database of all adult transplant patients at a university medical center was cross-referenced with a computerized record of all ED visits over an 18-month period. ED charts, inpatient records, and microbiology data were retrospectively reviewed. Final diagnoses and outcomes were analyzed. There were 352 ED visits by transplant patients (kidney 66%, kidney/pancreas 15%, liver 13%, lung 3%, heart 3%). Infections were the most common indications for admission (77/217, 35%). Urinary tract infection and pneumonia were the most common infections. Nine of 77 patients (11.7%) with documented infections developed severe sepsis, which was the most common reason for ICU utilization. Thirty-five percent of transplant patients admitted from the ED had acute infections, and 11.7% of these patients had severe sepsis. The emergency physician must have a high index of suspicion for infections when evaluating organ transplant recipients.

MeSH terms

  • Adult
  • Bacterial Infections / epidemiology*
  • Critical Care / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Heart Transplantation / statistics & numerical data
  • Hospital Mortality
  • Hospitals, Teaching
  • Hospitals, Urban
  • Humans
  • Incidence
  • Kidney Transplantation / statistics & numerical data
  • Liver Transplantation / statistics & numerical data
  • Lung Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Pancreas Transplantation / statistics & numerical data
  • Patient Admission / statistics & numerical data
  • Pneumonia, Bacterial / epidemiology
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Sepsis / epidemiology*
  • Transplants / statistics & numerical data*
  • Urinary Tract Infections / epidemiology