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从血流感染供体中进行肾脏移植:一项多中心回顾性研究。

Kidney Transplantation From Deceased Donors With Bloodstream Infection: A Multicenter Retrospective Study.

机构信息

Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2022 Jan 3;37(1):e4. doi: 10.3346/jkms.2022.37.e4.

Abstract

BACKGROUND

The use of organs from donors with infection is limited because of the possibility of transmission. We aimed to investigate the transmission after deceased donor transplantation with bloodstream infection (BSI).

METHODS

A retrospective study of patients undergoing kidney or pancreas transplantation at five tertiary centers in Korea from January 2009 and November 2019 was performed. We analyzed the outcomes after transplantation from deceased donors with BSI.

RESULTS

Eighty-six recipients received transplantation from 69 donors with BSI. The most common isolated pathogens from donors were Gram-positive bacteria (72.0%), followed by Gram-negative bacteria (22.7%), and fungi (5.3%). Appropriate antimicrobial agents were used in 47.8% of donors before transplantation. Transmission occurred only in 1 of 83 recipients (1.2%) from bacteremic donors and 1 of 6 recipients (16.7%) from fungemic donors. One-year patient and graft survival was 97.5%and 96.3%, respectively. There was no significant difference in graft and patient survival between patients who received organs from infected donors and noninfected donors.

CONCLUSION

Using organs from donors with bacteremia seems to be a safe option with low transmission risk. The overall prognosis of using organs from donors with BSI is favorable.

摘要

背景

由于存在传播的可能性,因此感染供体的器官的使用受到限制。我们旨在研究因血流感染(BSI)导致的已故供体移植后的传播情况。

方法

对 2009 年 1 月至 2019 年 11 月在韩国五个三级中心接受肾或胰腺移植的患者进行了回顾性研究。我们分析了来自 BSI 已故供体移植后的结果。

结果

86 名受者接受了 69 名 BSI 供者的移植。供体中最常见的分离病原体是革兰阳性菌(72.0%),其次是革兰阴性菌(22.7%)和真菌(5.3%)。在移植前,有 47.8%的供体使用了适当的抗菌药物。仅在 1 名来自菌血症供体的 83 名受者(1.2%)和 1 名来自真菌血症供体的 6 名受者(16.7%)中发生了传播。1 年患者和移植物存活率分别为 97.5%和 96.3%。在从感染供体和非感染供体接受器官的患者之间,移植物和患者的存活率没有差异。

结论

使用来自菌血症供体的器官似乎是一种安全的选择,其传播风险较低。使用 BSI 供体器官的总体预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ef9/8723893/d439fb2309a2/jkms-37-e4-g001.jpg

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