Characteristics of infectious complications associated with mortality after solid organ transplantation

Shawn J. Pelletier, Traves D. Crabtree, Thomas G. Gleason, Daniel P. Raymond, Chang Kwon Oh, Timothy L. Pruett, Robert G. Sawyer

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Infection remains a common source of morbidity and mortality after solid organ transplantation. The purpose of this study was to characterize the continuously changing patterns of post-transplantation infections, analyze early post-transplantation infections, and evaluate characteristics associated with mortality. A secondary analysis was performed on prospectively collected data for all episodes of infection occurring between 10 December 1996 and 28 October 1998 on the surgery services at a university medical center. Post-transplantation infections were compared with those in non-transplantation patients randomly matched by severity of illness. Further analysis was performed on post- transplantation infections occurring during the admission of transplantation compared with those in subsequent admissions. To evaluate factors associated with mortality, episodes occurring in survivors and non-survivors were compared. The results demonstrated that infections in transplantation recipients (n = 303) were associated with a younger age and had significantly lower white blood cell counts (WBC) compared with non-transplantation patients. There was no difference in mortality (15.5 vs. 16.5%, p = 0.74). Post-transplantation infectious complications during the initial hospitalization (n = 105) occurred at 38 ± 6 compared with 695 ± 66 d (p < 0.0001) after transplantation and were associated with a longer length of stay (LOS) and increased mortality (30.5 vs. 7.6%, p < 0.0001) compared with those occurring in subsequent admissions (n = 198). Although multiple characteristics of post-transplantation infections were associated with mortality, only the Acute Physiology and Chronic Health Evaluation (APACHE) II score was an independent predictor of mortality. Post-transplantation infections remain a significant source of morbidity and mortality. The leukocyte response to infection was suppressed in the transplantation population. Post-transplantation infections which occur during the admission for transplantation have a markedly increased mortality.

Original languageEnglish (US)
Pages (from-to)401-408
Number of pages8
JournalClinical Transplantation
Volume14
Issue number4 II
DOIs
StatePublished - 2000

Keywords

  • Infection
  • Morbidity
  • Mortality
  • Post-transplantation
  • Solid organ

Fingerprint

Dive into the research topics of 'Characteristics of infectious complications associated with mortality after solid organ transplantation'. Together they form a unique fingerprint.

Cite this