1085. Bacterial, Fungal, and Parasitic Infections One Year After Isolated Intestinal and Multivisceral Transplantation in a Single Center
Session: Poster Abstract Session: Infections After Solid Organ Transplants
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • IDSAtxplposter2011.pdf (133.4 kB)
  • Background: Infectious complications are common after multivisceral (MV) and isolated intestinal transplant.  Near two decades after the introduction of this surgical modality, there is no literature describing the affected sites and spectrum of infecting pathogens. The objective of this study is to assess the relative risk and spectrum of infections in multivisceral (MV; stomach, pancreas, intestine, ± liver) and isolated intestinal transplant recipients during the first year post-transplantation.

    Methods: This single center study is a retrospective medical record review of 121 patients who underwent intestinal and MV transplantation from 2004 to 2009. Statistical analysis stratified patients by age (adult/pediatric) and transplant type (intestine alone/MV).

    Results: 533 infections were identified. The most common infectious complications involved the bloodstream (235, 44%) and urinary tract (159, 28%); pulmonary (45, 8%) and intra-abdominal infections (32, 6%) were less frequent.  The most common bacteria were Pseudomonas aeruginosa, Enterococcus species, and Klebsiella pneumoniae.  Fungal infections were dominated by Candida (68 of 71, 95%), with Candida glabrata being the most common (39, 54%). Clinically significant mycobacterial and parasitic infections were uncommon in the first year post transplantation. The mean number of infections per patient was 5.2 in the isolated intestinal transplant group; 4.2 in the MV transplant group.  Surprisingly, the adult intestine alone group had a greater mean number of bloodstream infections (3.2 vs 1.7, p=0.01) and fungal infections (1.0 vs 0.4, p=0.01) than the adult MV group. 

    Conclusion:  Isolated intestinal and MV transplant recipients are at high risk of bacterial and fungal infections.   Isolated intestinal transplantation carried a greater risk of infection compared to MV transplantation.  In all groups the most common sites of infection were the bloodstream and urinary tract, therefore, strategies to minimize these risks are likely to provide significant benefits in this patient population.


    Subject Category: O. Transplant infectious diseases

    Vera M. Rosado-Odom, MD, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, Raymond Johnson, MD, PhD, University of Indiana School of Medicine, Indianapolis, IN and Richard S. Mangus, MD, Department of Surgery, Transplant Section, Indiana University School of Medicine, Indianapolis, IN

    Disclosures:

    V. M. Rosado-Odom, None

    R. Johnson, None

    R. S. Mangus, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.