Factors Affecting the Frequency of Infection in Renal Transplant Recipients

Murphy, Joann

doi:10.1001/archinte.1976.03630060022006

Cited by 65 publications

(18 citation statements)

References 21 publications

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“…The kidney transplant patient is subject, for example, to infection, 14 hyperlipidemia, 15 myocardial infarction, 16 cerebrovascular accident, 16 psychiatric difficulties, 17 GI tract complications, including peptic ulcer disease with gastroduodenal bleeding or perforation, 18,19 pancreatitis, 20 hepatitis and liver failure, 21 colon perforation, 22 and cancer. 23 In the early years, technical accidents were responsible for a number of perioperative deaths.…”

Section: Commentmentioning

confidence: 99%

Causes of Death After Kidney Transplantation

Washer¹

1983

JAMA

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Durtng the five-year period September 1074 through August '1979"two to the many physicians outside transhundred nine consecutive patients rec,lved their first kidney transplant In plant ~nterswho are now caring for Denver. During 2.5 to 7.5' years of foDow-up. 54 paUents (28%) died. kidney transplant patients. Infection was the leading cause of death during .. Interval. and was METHODS re.ponslble for 22 (41%) of the 54 deaths. Pneumonia was prtmarUy We, have reviewed the results of 209 re.ponslble for 14 of the 22 deaths from Infection. The other cau.e. of death CODSeCUtive patients who received their were cardiovascular problems In11 patient. (20%), suicide In eight paUents first kidney transplant at the University (15%). gastrOintestinal (GI) tract problems In .. ven paUents (13%), mangnsnt of Colorado Health Sciences Center and neopla.ms In two patient. (4%), and miscellaneous probIems-ln-four-paUentsthe Dcm¥R VeterlUlLAdminiatntioQ Hoe----' ,-'(7%). Twenty-alx ,(48%) of the 54 deaths occurred more than one year after pital during the fi.,.-year period Septemprtmary'transplantatlon; 12 of these 28 patlenla had already returned to ber 19"l4 throush August 1979. By meaDS of inpatient chart review, outpatient chart chronic hemodialysis. To minimize mortality atter transplantation, patients review, and telephone calldo patients and and their physician. must remain alert to the ongoing rt.ks to which the.. ,families, follow-up information for all paUent. are exposed, Including the rI.ks of sudden death from Infection.patients has been updated to Feb 1. U82. myocardial Infarction, pulmonary embolu., SUicide, or GI tract perforation. ~ range .or,foU cnr -Il P for the.155 lllniv-(JAifA 1983;250:4~54) • .. " ' / . 0 . patients ia 2.5 to 1.5, JUI'I (mean, 58 . ,. . months). Patients• _ho received a lint _ . ~ -' '~Diney transplaDt before •September 19'14

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Section: Commentmentioning

confidence: 99%

Causes of Death After Kidney Transplantation

Washer¹

1983

JAMA

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“…The most common infection in renal transplant recipi ents is urinary tract infection which has a benign clinical course and usually improves with appropriate antibiotics [1], However, bacterial allograft pyelonephritis often ac companies renal failure and, in a severe case, dialysis ther apy is needed [2], In renal transplants, the possible causes of acute pyelo nephritis-related renal failure are hypovolemia, over whelming sepsis, drug-induced (antibiotics or cyclosporin A) nephrotoxicity and infection-triggered rejection. These factors are so complicated that evaluation of renal failure in acute allograft pyelonephritis is important in the man agement of renal transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Acute Renal Failure in Bacterial Allograft Pyelonephritis Using Abdominal CT and Graft Biopsy

Yang

Lee²,

Choi³

et al. 1997

Am J Nephrol

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The causes of acute renal failure in bacterial allograft pyelonephritis were evaluated using abdominal CT and graft biopsy. Twenty-one recipients, who showed a poor response to antibiotic therapy, comprised this study group. The diagnostic approach taken with this poor responder group was first to perform abdominal CT. If a focal lesion was identified on abdominal CT, a diagnosis of acute focal bacterial nephritis or renal abscess was made. If no focal lesion was found, a graft biopsy was performed for diagnosis. Abdominal CT revealed focal lesions in 9 of the 21 recipients, and renal biopsy showed superimposed acute rejection in 8 of the 12 recipients biopsied. In conclusion, acute renal failure in allograft pyelonephritis is associated with not only severe infection but also a superimposed acute rejection process. Therefore, imaging study and graft biopsy are recommended in the poor responder group.

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“…Previous studies in kidney recipients have found meningitis to be the most common clinical presentation of cryptococcosis [7,13,19,221, and an uncontrolled study in liver transplant recipients [24] suggested that cutaneous or osteoarticular lesions might be more frequent than meningitis. However, the small sample size of some of these studies and the lack of comparison between different types of SOT recipients with cryptococcosis have precluded a comprehensive assessment of this fungal infection in this patient population.…”

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confidence: 99%

Longitudinal study of cryptococcosis in adult solid-organ transplant recipients

Vilchez¹,

Shapiro²,

McCurry³

et al. 2003

Transplant Int

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While studies in kidney recipients have found meningitis to be the most common clinical manifestation of cryptococcosis (Cry), it is unclear if the clinical presentation of Cry differs among various solidorgan transplant (SOT) recipients and whether the serum cryptococcal antigen (SCA) might predict the site of infection. We report the clinical manifestations and the correlation with a positive SCA among 55 consecutive SOT recipients diagnosed with Cry at the University of Pittsburgh Medical Center. These included: heart (n = 13), lung (n = 4), liver (n = 28), kidney (n = 9) and small bowel (n = 1) recipients. While there were no significant differences in the manifestations of Cry in heart and lung recipients, kidney recipients had disseminated disease as the most common presentation ( P = 0.02). In contrast, pneumonia ( P = 0.003) and meningitis ( P = 0.02) were more frequent than disseminated disease in liver recipients. Positive SCA was higher in patients with disseminated disease and meningitis than in patients with isolated pneumonia ( P = 0.0001). Significant differences in the manifestations of Cry were observed among types of SOT populations. A positive SCA may be predictive of dissemination and meningitis, but it may not be sensitive for pulmonary disease.

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Factors Affecting the Frequency of Infection in Renal Transplant Recipients

Cited by 65 publications

References 21 publications

Causes of Death After Kidney Transplantation

Causes of Death After Kidney Transplantation

Evaluation of Acute Renal Failure in Bacterial Allograft Pyelonephritis Using Abdominal CT and Graft Biopsy

Longitudinal study of cryptococcosis in adult solid-organ transplant recipients

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