title: Infections related to renal transplantation requiring intensive care admission: a 20-year study.
abstract: BACKGROUND
  The aim of this study was to evaluate infection complications as the reason for intensive care unit (ICU) admission among transplant recipients.
  
  
  METHODS
  We studied all renal transplant recipients with infectious complications admitted to our ICU from 1992 to 2012:44.3% of all renal transplant recipients admitted to ICU. The epidemiology and prognosis of infectious complications requiring ICU admission were evaluated with analysis of mortality factors.
  
  
  RESULTS
  The 22 men and 5 women included in this study showed a mean age of 42.7 ± 12.3 years. The Acute Physiologic and Chronic Health Evaluation II and Seguential Organ Failure Assessment scores on ICU admission were 20 ± 4.6 and 8.6 ± 3.9, respectively. The main infections complications requiring ICU admission were cytomegalovirus pneumonia (n = 15) and aspergillus pneumonia (n = 4). Sixteen patients required hemodialysis and 14, catecholamine support upon ICU admission owing to septic shock. The mortality rate among study patients was 62.9%, versus 26.5% for noninfectious renal transplant recipients requiring ICU admissions. Catecholamine support at ICU admission was independently related to mortality.
  
  
  CONCLUSIONS
  The mortality rate of renal transplant recipients admitted to ICU owing infection complications was higher than that of noninfected renal transplant patients. These data suggest that infections and septic shock in renal transplant recipients requiring ICU admission worsen their outcome significantly.
authors.affiliation: Intensive Care Unit, "Hippokratio" University Hospital, Thessaloniki, Greece. elmoulou@yahoo.gr
authors.forename: E
authors.initials: E
authors.lastname: Mouloudi
authors.forename: E
authors.initials: E
authors.lastname: Massa
authors.forename: E
authors.initials: E
authors.lastname: Georgiadou
authors.forename: E
authors.initials: E
authors.lastname: Iosifidis
authors.forename: E
authors.initials: E
authors.lastname: Katsika
authors.forename: G
authors.initials: G
authors.lastname: Rembelakos
authors.forename: D
authors.initials: D
authors.lastname: Gakis
authors.forename: G
authors.initials: G
authors.lastname: Imvrios
authors.forename: V
authors.initials: V
authors.lastname: Papanikolaou
authors.forename: S
authors.initials: S
authors.lastname: Papadopoulos
authors.forename: N
authors.initials: N
authors.lastname: Gritsi-Gerogianni
mesh_terms: D018806:APACHE; D000328:Adult; D002395:Catecholamines; D003141:Communicable Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063305:Organ Dysfunction Scores; D010343:Patient Admission; D011446:Prospective Studies; D006435:Renal Dialysis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines