title: Donor positive blood culture is associated with delayed graft function in kidney transplant recipients: a propensity score analysis of the UNOS database.
abstract: BACKGROUND
  The effect of blood culture positive donor (BCPD) on delayed graft function (DGF) in kidney transplant recipients has not been well established.
  
  
  METHODS
  We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor kidney transplantation in US between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. We used propensity scores for 1:1 matching of BCPD and non-BCPD cohorts. DGF, graft and patient survival at one yr were compared between cohorts using multivariable logistic and Cox regression models. DGF was defined as requiring dialysis within the first week post-transplant.
  
  
  RESULTS
  There were 4126 (8.1%) recipients of BCPD during the study period. DGF was associated with BCPD (aOR; 1.15, 95% CI 1.07-1.24). This association was maintained in the propensity-score matched analysis (p < 0.01). No association was found between BCPD and graft survival (aHR; 1.01, 95% CI, 0.92-1.09) or patient survival (aHR; 0.92, 95% CI, 0.82-1.04).
  
  
  CONCLUSIONS
  Blood culture positive donor was associated with DGF but did not impact graft or patient survival in deceased-donor kidney transplants. This suggests a transient negative effect of BCPD that does not appear to translate into a more persistent deleterious outcome.
authors: Division of Infectious Diseases, Department of Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.
authors: Moises A
authors: MA
authors: Huaman
authors: Department of Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
authors: Valery
authors: V
authors: Vilchez
authors: Section of Transplant Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
authors: Xiaonan
authors: X
authors: Mei
authors: Section of Transplant Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
authors: Daniel
authors: D
authors: Davenport
authors: Section of Transplant Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
authors: Roberto
authors: R
authors: Gedaly
mesh_terms: D000328:Adult; D000071997:Blood Culture / Q000379:methods*; D016022:Case-Control Studies; D016208:Databases, Factual; D051799:Delayed Graft Function / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D066027:Transplant Recipients
keywords: bacteremia; delayed graft function; infection; kidney transplantation; survival analysis