Sepsis outcomes in solid organ transplant recipients.

Area of Science:

• Critical Care Medicine
• Transplant Surgery
• Infectious Diseases

Background:

• Sepsis poses a significant threat to patient outcomes, particularly in vulnerable populations such as solid organ transplant (SOT) recipients.
• Understanding sepsis-related mortality and morbidity in SOT recipients compared to non-SOT patients is crucial for optimizing care.

Purpose of the Study:

• To compare sepsis outcomes between solid organ transplant (SOT) recipients and non-SOT patients over a 10-year period.
• To identify specific SOT subgroups with differential sepsis-related mortality and morbidity.

Main Methods:

• Retrospective single-center study of sepsis patients from January 2006 to June 2016.
• Propensity score matching was used to compare SOT recipients (n=1670) with non-SOT patients (n=1670).
• Conditional logistic regression and repeated measurement models analyzed binary outcomes, while trend analysis and gamma-distributed models assessed mortality and continuous variables.

Main Results:

• Overall in-hospital mortality for sepsis showed a decreasing trend over time in both SOT and non-SOT patients.
• Despite higher comorbidities, SOT patients had similar in-hospital mortality to non-SOT patients (OR=1.14).
• Heart and lung SOT subgroups exhibited significantly higher mortality (OR=1.83 and OR=1.77, respectively). SOT patients had longer hospital stays, increased 30-day readmissions, and higher odds of disseminated intravascular coagulation (DIC).

Conclusions:

• Sepsis in SOT recipients generally has similar mortality rates to non-SOT patients, but heart and lung transplant recipients represent a high-risk subgroup.
• SOT patients with sepsis experience higher rates of hospital readmission and DIC compared to non-transplant patients.