Contamination of preservation fluid in kidney transplantation: single-center analysis.
BACKGROUND
Contamination of preservation fluid is common, with a reported incidence of 2.2% to 28.0%, and may be a major cause of early morbidity after transplantation. Herein, we report our experience with routine examination of preservation fluid collected just before implantation, focusing on the rate of contamination and the clinical consequences to recipients.


METHODS
We analyzed 62 samples of preservation fluid for microbial and fungal contamination.


RESULTS
Twenty-four samples (38.7%) were contaminated with at least 1 organism. Bacterial contamination alone was observed in 18 samples; all patients received prophylactic treatment with intravenous piperacillin/tazobactam, 4.5 g/d for 10 days, without clinical sequelae. Six samples were contaminated with Candida species; all patients received prophylactic treatment with fluconazole, 100 mg/d for 3 months. One patient developed reversible acute renal failure due to ureteral obstruction by fungus balls at 30 days after transplantation.


CONCLUSIONS
Contamination of preservation fluid occurs frequently after kidney transplantation. Bacterial contamination evolved without symptoms in most patients treated with prophylactic antibiotic therapy. Fungal contamination may be potentially life-threatening. However, graft nephrectomy is not mandatory if the involved Candida species is identified correctly and appropriate antifungal therapy is rapidly prescribed.
Department of Surgery, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy. veroux@unict.it
M
M
Veroux
D
D
Corona
V
V
Scriffignano
P
P
Caglià
M
M
Gagliano
G
G
Giuffrida
F
F
Gona
A
A
Sciacca
A
A
Giaquinta
S
S
Oliveri
N
N
Sinagra
T
T
Tallarita
D
D
Zerbo
M
M
Sorbello
L
L
Parrinello
P
P
Veroux
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification*; D000077552:Basiliximab; D002175:Candida / Q000302:isolation & purification*; D004340:Drug Contamination / Q000706:statistics & numerical data*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000592:standards*; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000009:adverse effects / Q000592:standards*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D000935:Antifungal Agents; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D019188:Organ Preservation Solutions; D011993:Recombinant Fusion Proteins; D015725:Fluconazole; D000077552:Basiliximab