Rizvi S J, Chauhan R, Gupta R, Modi P
G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre-Dr. H.L. Trivedi Institute of Transplantation Sciences, Gujarat, India.
Transplant Proc. 2008 May;40(4):1117-8. doi: 10.1016/j.transproceed.2008.03.075.
Renal transplant recipients are susceptible to postoperative infections, among which those in the urinary tract (UTI) are the most common. We examined the effect of pretransplant bacterial UTI on the incidence of posttransplant UTI as well as complications and short-term outcomes.
We examined the case records of 100 patients who underwent living-related donor renal transplantation at our institute from November 2006 to June 2007.
Nineteen patients had positive pretransplant bacterial urine cultures and four required native nephrectomy for control of persistent bacterial UTI. All patients were transplanted under a tolerance induction protocol using low-dose immunosuppression after negative suprapubic culture reports. There was no urinary leak/obstruction or vascular complication. The incidence of postoperative bacterial UTI was 31.6% (6 of 19) compared with 6.2% (6 of 81) among patients without pretransplant UTI. E. coli was the most common isolated organism. All patients were doing well with 100% graft survival at 3 months and a mean serum creatinine of 1.27 mg%.
Preoperative UTI predicted an increased likelihood of postoperative UTI without a significant effect on graft/patient survival and graft function.
肾移植受者易发生术后感染,其中尿路感染(UTI)最为常见。我们研究了移植前细菌性UTI对移植后UTI发生率以及并发症和短期预后的影响。
我们检查了2006年11月至2007年6月在我院接受亲属活体供肾移植的100例患者的病例记录。
19例患者移植前细菌尿培养呈阳性,4例因持续性细菌性UTI的控制而需要进行自体肾切除术。所有患者在耻骨上培养报告为阴性后,均采用低剂量免疫抑制的耐受性诱导方案进行移植。未发生尿漏/梗阻或血管并发症。移植前有UTI的患者术后细菌性UTI发生率为31.6%(19例中的6例),而移植前无UTI的患者中这一发生率为6.2%(81例中的6例)。大肠杆菌是最常见的分离菌。所有患者情况良好,3个月时移植肾存活率为100%,血清肌酐平均为1.27mg%。
术前UTI预示着术后UTI的可能性增加,但对移植肾/患者的存活及移植肾功能无显著影响。