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Factors affecting the frequency infection in renal transplant recipients
Abstract:
A retrospective review of 149 patients receiving 162 renal transplants showed that 83% of these patients developed one or more infections during a follow-up period averaging one year. In 32 (73%) of 44 deaths, infection was an important contributing cause. In only four (9%) of the deaths were the patients free of infection at the time of death. The Klebsiella-Enterobacter group was the most common agent causing pneumonitis and sepsis. Cryptococcus neoformans caused seven of 11 cases of meningitis. Pseudomonas was the most frequent agent associated with infections documented during postmortem examinations. In a short-term controlled study comparing daily and alternate daily therapy with prednisone, the alternate daily group had significantly (P less than .05) more infections per patient, especially in patients who had no evidence of rejection (P less than .025).
Insights
Renal transplant recipients frequently experience infections, often contributing to death. Alternate-day prednisone therapy increased infection rates, particularly in patients without rejection.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunosuppression
Background:
- Renal transplantation is a life-saving procedure, but recipients are susceptible to infections.
- Understanding infection patterns and risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze infection incidence and causes in renal transplant patients.
- To evaluate the impact of prednisone dosing frequency on infection rates.
Main Methods:
- Retrospective review of 162 renal transplants in 149 patients over a one-year average follow-up.
- Short-term controlled study comparing daily versus alternate daily prednisone therapy.
Main Results:
- 83% of patients developed infections; infection contributed to 73% of deaths.
- Klebsiella-Enterobacter caused common pneumonitis and sepsis; Cryptococcus neoformans caused meningitis; Pseudomonas was frequent in postmortem exams.
- Alternate-day prednisone significantly increased infections (P<0.05), especially in non-rejection cases (P<0.025).
Conclusions:
- Infections are a major complication after renal transplantation.
- Prednisone's alternate-day regimen may increase infection risk in renal transplant recipients.