Severe infections requiring intensive care unit admission in kidney transplant recipients: impact on graft outcome

Abstract

Sepsis was chiefly related to bacterial pneumonia or urinary tract infection. Pneumocystis jirovecii was the leading opportunistic agent, with a trend toward an increase over time. Infections often induced severe graft function impairment. Baseline creatinine and cyclosporine therapy independently predicted the outcome.

Factors associated with hospital mortality in renal transplant patients admitted to the intensive care unit with acute respiratory failure

“…This finding is no different from other studies in this population, which report severe pulmonary complications more frequently after 6 months of transplantation, 8,9,16,18,23,24,27 although there are cases with different results. 17,28 Cardiogenic pulmonary edema is another condition often implicated in the genesis of ARF.…”

“…21 It is important to note that although urinary infection is the most common in the renal transplant, 22 pulmonary infection is the main cause of sepsis and hospitalization in the ICU. 8,10,23,24 Traditionally, a greater number of infections are expected in the first 6 months of transplantation, a period in which immunosuppression is more intense. 25,26 However, it is interesting to note that patients included in this study had on average more than 5 years of transplantation.…”

Death and kidney allograft dysfunction after bacteremia

“…In addition, we consider that rituximab may induce earlyonset neutropenia in case 3 [21]. The characteristics of Although UTI was the leading cause of bacteremia, respiratory tract infections were the primary cause of infections requiring ICU admission (accounted for 54 %) in KTR [22]. In our current cohort, both recipients who developed pneumonia were in septic shock and died subsequently.…”

“…Similarly, a recent study showed that ICU-requiring severe infections in KTR had a significant impact on kidney allograft function. In particular, 47 % of the recipients who were alive had recovered their previous graft function, and 31 % had impaired graft function, including 19 % who were dependent on renal replacement therapy 90 days after ICU discharge [22]. In our current study, 3 recipients who required ICU admission died of infections.…”

The diagnostic yield and complications of open lung biopsies in kidney transplant patients with pulmonary disease

“…Infectious diseases are the most common causes of pulmonary complications. Pulmonary infections are the main cause of acute respiratory failure (7) and severe sepsis (10)(11)(12), while community-acquired pneumonia is the leading cause of admission to the intensive care unit (ICU) (13). The incidence of neoplasia and drug-related pulmonary toxicity is lower (7,14,15).…”