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|
|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|
|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|
|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 (%)
X. Mei, None
D. Davenport, None
R. Gedaly, None
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