Impact of graft infection on long-term survival after kidney transplant.
BACKGROUND
Patients undergoing transplantation procedures are at a high risk of developing infections because of the need for immunosuppression. Infections presenting directly after renal transplantation greatly influence the overall success of the procedure. The aim of this study was to evaluate the influence of postoperative infection on the length of survival after renal transplant.


METHODS
In 2009 a multicenter prospective trial evaluating the factors that influence the occurrence of postoperative infective complications was published by the authors. That study reported that 25 out of 232 recipients of a renal transplant were diagnosed with an infection. The present study shows the effect of postoperative infection on the length of survival after renal transplantation during a 15-year observation period. Statistical methods involved monofactorial and multifactorial Kaplan-Meier analysis for the length of survival and the Cox proportional hazards model for mortality prediction. A P value of <.05 was considered to indicate statistical significance.


RESULTS
The analysis demonstrated that the lifespan of renal transplant recipients was decreased in those with postoperative infection, at both year 10 of the observation period (P = .013) and 15 years after transplantation (P = .012). Moreover, it was ascertained that an infection in the postoperative period was an independent risk factor increasing the mortality after renal transplantation: P = .026; hazard ratio 2.90 (95% confidence interval, 1.13-7.41).


CONCLUSIONS
The occurrence of an infection in the postoperative period significantly decreases the lifespan of a renal transplantation recipient.
Clinical Microbiology, Teaching Hospital No 2, Pomeranian Medical University, Szczecin, Poland.
A
A
Zukowska
Department of Anesthesiology, Intensive Care, and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland.
K
K
Kotfis
Department of Laboratory Diagnostic and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland.
M
M
Kaczmarczyk
Department of Anesthesiology, Intensive Care, and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland.
J
J
Biernawska
Department of Anesthesiology, Intensive Care, and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland.
L
L
Szydłowski
Clinic of General and Transplant Surgery, Pomeranian Medical University, Szczecin, Poland.
T
T
Sulikowski
Clinic of General and Transplant Surgery, Pomeranian Medical University, Szczecin, Poland.
A
A
Sierocka
Clinic of General and Transplant Surgery, Pomeranian Medical University, Szczecin, Poland.
J
J
Pawlus
Clinic of Anesthesiology and Intensive Care, Pomeranian Medical University, Szczecin, Poland.
R
R
Bohatyrewicz
Department of Anesthesiology, Intensive Care, and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland. Electronic address: zukowski@sci.pam.szczecin.pl.
M
M
Zukowski
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy; D007239:Infections / Q000401:mortality*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors