Outcomes of Kidney Transplant Recipients With Posttransplant Genitourinary Infectious Complications: A Single Center Study

Exp Clin Transplant. 2019 Aug;17(4):470-477. doi: 10.6002/ect.2017.0196. Epub 2018 Oct 24.

Abstract

Objectives: Long-term outcomes of kidney transplant recipients with postoperative genitourinary tract infections are not well characterized. In this single center retrospective study, we aimed to investigate the long-term effects of early posttransplant genitourinary infections under a protocol that included 1 month of antibiotic prophylaxis on graft failure and patient outcomes.

Materials and methods: Electronic medical records of 1752 recipients of kidney-alone transplant between January 2000 and December 2008 were reviewed. Of these, 344 patients had postoperative genitourinary tract infections within 6 months of transplant. Infections included urinary tract infections, recurrent urinary tract infections, and pyelonephritis. All patients received 1-month of treatment with antibiotic prophylaxis for genitourinary infections after graft placement. Kaplan-Meier survival curves and multivariable regression modeling were performed to determine survival outcomes.

Results: In the 344 patients with postoperative infections, the most common cause was Escherichia coli (34.9%). Kaplan-Meier graft survival results showed no significant differences (P = .08) among those with and those without postoperative urinary tract infections; however, patient survival (P = .01) was significantly different. Multivariate analysis demonstrated no significant trend regarding graft failure (hazard ratio: 1.28; 95% confidence interval, 0.95-1.71; P = .09) or patient death (hazard ratio: 1.33; 95% confidence interval, 0.98-1.79; P = .06) in patients with and without genitourinary infections. The major cause of graft failure was infection in the infection cohort (17.4%).

Conclusions: Kidney transplant recipients who develop urinary tract infections within 6 months of transplant may be at increased risk of graft failure or patient death; however, further studies are needed to elucidate the relationship between posttransplant infections and long-term outcomes.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Electronic Health Records
  • Female
  • Graft Survival
  • Humans
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Reproductive Tract Infections / diagnosis
  • Reproductive Tract Infections / drug therapy*
  • Reproductive Tract Infections / microbiology
  • Reproductive Tract Infections / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / mortality
  • Young Adult

Substances

  • Anti-Bacterial Agents