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Single-center analysis of infectious complications in older adults during the first year after kidney transplantation

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Abstract

Infections are among the top three causes of death of older adults in the first year after kidney transplantation (KT). Our aim was to describe infectious complications among KT recipients aged ≥ 65 during the first 12 months post-transplant. Single-center retrospective cohort study. Ninety-one KTs had been performed in patients ≥ 65 years of age between 2011 and 2015. 92.3% of the patients developed at least one infection. Infectious episodes increased the risk of future infection by 10% (p = 0.0018) with each infection portending a greater risk. At a patient level, viral (71.4%) and bacterial (70.2%) infections predominated. Urinary tract infections were the most frequent complication (30.3%), followed by cytomegalovirus infections (22.7%). Infections were the main reason for readmission. 7.7% of the patients developed rejection; and overall 3.3% lost their graft. Mortality at 1 year was 9.9%. Older KT recipients have a high incidence of infectious complications the first year after KT. Infections were the number one reason for readmission, and an infection episode predicted future infections for the individual patient. Despite these complications, the majority of older KT recipients were alive with a functioning graft at 1 year.

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Funding

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health under award number 5T32AI100851 (MHM, BDA). Dr. Schmader was supported by the National Institute on Aging, Duke Pepper Older Americans Independence Center P30AG028716.

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Authors and Affiliations

  1. Division of Infectious Diseases, Duke University Medical Center, Box 102359, Durham, NC, 27710, USA

    Marion Hemmersbach-Miller & Barbara D. Alexander

  2. Division of Abdominal Transplant Surgery, Duke University Medical Center, Durham, NC, USA

    Debra L. Sudan

  3. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA

    Carl Pieper

  4. Division of Geriatrics, Duke University Medical Center, Durham, NC, USA

    Kenneth E. Schmader

  5. GRECC, Durham VA, Durham, NC, USA

    Kenneth E. Schmader

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  1. Marion Hemmersbach-Miller
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Correspondence to Marion Hemmersbach-Miller.

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Hemmersbach-Miller, M., Alexander, B.D., Sudan, D.L. et al. Single-center analysis of infectious complications in older adults during the first year after kidney transplantation. Eur J Clin Microbiol Infect Dis 38, 141–148 (2019). https://doi.org/10.1007/s10096-018-3405-5

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