1221. Blood Culture Positive Donor is Associated with Delayed Graft Function in Kidney Transplant Recipients: An Analysis of UNOS Database
Session: Poster Abstract Session: Transplant: Epidemiology of Infections in Transplant Patients and Other Patients with Impaired Immunity
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Poster_IDWeek_MoisesHuaman_10_1_2015.pdf (159.4 kB)
  • Background: The potential effect of blood culture positive donor (BCPD) on delayed graft function (DGF) in kidney transplant recipients has not been well established.     

    Methods:  We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor kidney transplantation in the US between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. DGF, graft and patient survival at 30 days and 1 year were compared between cohorts using multivariable logistic regression for DGF and Cox Proportional Hazard models for graft and patient survival. DGF was defined as requiring dialysis within the first week post-transplant.

    Results: A total of 51,048 patients were included in the analysis. There were 4,126 (8.1%) recipients of BCPD. Baseline characteristics are shown in the Table. BCPD were more likely to be older, diabetics and have higher body mass index compared to non-BCPD. Recipients of BCPD were more likely to be males, diabetics and have had longer pre-transplant dialysis compared to recipients of non-BCPD. In multivariable analysis, DGF was associated with BCPD (adjusted OR, 1.15; 95% CI 1.07 – 1.24; P<0.01). No association was found between BCPD and graft or patient survival.

    Conclusion: BCPD was associated with DGF but did not impact graft or patient survival in deceased-donor kidney transplants. This suggests a transient negative effect of BCPD that does not appear to translate into a more persistent deleterious outcome. Adequately powered studies looking at the effect of specific pathogens, antimicrobial therapy and immunosuppression early after kidney transplantation in recipients of BCPD are warranted.

    Table. Baseline characteristics
    Variable Non-BCPD (n=46,922)            BCPD (n=4,126)                  P value   
    Recipient
      Age 53.9 ± 12.9 54.2 ± 12.7 0.21
      Male sex 28,282 (60.2) 2,564 (62.1) 0.02
      Black race 15,748 (33.6) 1,425 (34.5) 0.20
      Body mass index 28.4 ± 5.4 28.5 ± 5.4 0.78
      Diabetes 17,701 (37.7) 1,620 (39.3) 0.05
    Donor
      Age 39.3 ± 16.7 39.9 ± 15.9 0.01
      Male sex 28,025 (59.7) 2,450 (59.4) 0.67
      Black race 6,565 (13.9) 621 (15.1) 0.06
      Body mass index 27.4 ± 6.8 28.1 ± 7.3 <0.01
      Diabetes 3,686 (7.9) 377 (9.1) 0.01
      Creatinine, mg/dL 1.15 ± 0.9 1.16 ± 0.9 0.54
    Transplantation
      HLA match 6/6 3,536 (7.5) 288 (7) 0.19
      Cold ischemic time, hours         17.7 ± 9.6 17.8 ± 9.1 0.75
      Delayed graft function 11,835 (25.2) 1,171 (28.4) <0.01

    * Data presented as mean ± SD or n (%)

    Moises Huaman, MD, MSc1, Valery Vilchez, MD2, Xiaonan Mei, MS2, Daniel Davenport, PhD2 and Roberto Gedaly, MD2, (1)Division of Infectious Diseases, Department of Medicine, University of Kentucky College of Medicine, Lexington, KY, (2)Section of Transplant Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY

    Disclosures:

    M. Huaman, None

    V. Vilchez, None

    X. Mei, None

    D. Davenport, None

    R. Gedaly, None

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