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单中心分析老年患者肾移植后 1 年内的感染性并发症。

Single-center analysis of infectious complications in older adults during the first year after kidney transplantation.

机构信息

Division of Infectious Diseases, Duke University Medical Center, Box 102359, Durham, NC, 27710, USA.

Division of Abdominal Transplant Surgery, Duke University Medical Center, Durham, NC, USA.

出版信息

Eur J Clin Microbiol Infect Dis. 2019 Jan;38(1):141-148. doi: 10.1007/s10096-018-3405-5. Epub 2018 Oct 23.

Abstract

Infections are among the top three causes of death of older adults in the first year after kidney transplantation (KT). Our aim was to describe infectious complications among KT recipients aged ≥ 65 during the first 12 months post-transplant. Single-center retrospective cohort study. Ninety-one KTs had been performed in patients ≥ 65 years of age between 2011 and 2015. 92.3% of the patients developed at least one infection. Infectious episodes increased the risk of future infection by 10% (p = 0.0018) with each infection portending a greater risk. At a patient level, viral (71.4%) and bacterial (70.2%) infections predominated. Urinary tract infections were the most frequent complication (30.3%), followed by cytomegalovirus infections (22.7%). Infections were the main reason for readmission. 7.7% of the patients developed rejection; and overall 3.3% lost their graft. Mortality at 1 year was 9.9%. Older KT recipients have a high incidence of infectious complications the first year after KT. Infections were the number one reason for readmission, and an infection episode predicted future infections for the individual patient. Despite these complications, the majority of older KT recipients were alive with a functioning graft at 1 year.

摘要

在肾移植(KT)后 1 年内,老年人的死亡原因中感染位居前 3 位。我们的目的是描述 KT 受者在移植后 12 个月内的感染并发症。单中心回顾性队列研究。2011 年至 2015 年间,91 例 KT 在年龄≥65 岁的患者中进行。92.3%的患者发生了至少一次感染。每次感染都会增加未来感染的风险 10%(p=0.0018)。在患者层面,病毒(71.4%)和细菌(70.2%)感染为主。尿路感染最为常见(30.3%),其次是巨细胞病毒感染(22.7%)。感染是再次入院的主要原因。7.7%的患者发生排斥反应;总共有 3.3%的患者失去了移植物。1 年死亡率为 9.9%。老年 KT 受者在 KT 后 1 年内感染并发症发生率较高。感染是再次入院的首要原因,感染发作预示着个体患者未来的感染。尽管存在这些并发症,但大多数老年 KT 受者在 1 年内仍存活且移植物功能正常。

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