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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation

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Clinical impact of bacterial contamination of perfusion fluid in kidney transplantation

A Ranghino1, D Diena1, F Simonato1

  • 1Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.

Springerplus
|January 14, 2016
PubMed

Insights

Perfusion fluid contamination is common in kidney transplant recipients, but infections are rare. Preemptive therapy for bacterial contamination did not reduce infection rates, suggesting a potential for reduced antibiotic use.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Clinical Microbiology

Background:

  • Perfusion fluid (PF) contamination poses a risk of serious infections in kidney transplant recipients.
  • Preemptive therapy (PE-T) is standard for yeast PF contamination, but its efficacy for bacterial contamination is uncertain.

Purpose of the Study:

  • To investigate the incidence of bacterial contamination in perfusion fluid (PF).
  • To evaluate the impact of preemptive therapy (PE-T) on clinical outcomes in kidney transplant recipients with bacterial PF contamination.

Main Methods:

  • Retrospective analysis of microbiological data from 290 perfusion fluids (PF) and clinical data from corresponding kidney transplant recipients (January 2010 - December 2012).
  • Recipients with bacterial PF contamination (n=101) were categorized into three groups: PE-T treated (resistant/sensitive to perioperative antibiotic prophylaxis - PAP) and PE-T untreated (resistant to PAP).

Main Results:

  • The incidence of positive PF was 34.8%, with staphylococci (50.4%) and Candida albicans (9.9%) being the most common contaminants.
  • No significant differences in PF-related infection rates were observed among the three treatment groups.

Conclusions:

  • Despite frequent PF contamination, the incidence of PF-related infections in kidney transplant recipients is low.
  • Preemptive therapy (PE-T) for bacterial PF contamination did not demonstrate a reduction in infection rates in this study.
  • Findings suggest a potential for reducing antibiotic therapy, pending confirmation from larger prospective trials. Close clinical and microbiological monitoring is recommended for recipients with PF contamination.
Keywords:
Bacterial contaminationKidney transplantPerfusion fluidPerioperative antibiotic prophylaxisPreemptive therapy

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