RT Journal Article
T1 Epidemiology, risk factors and impact on long-term pancreatic function of infection following pancreas-kidney transplantation
A1 Herrero Martínez, Juan María
A1 Lumbreras Bermejo, Carlos Juan
A1 Manrique Municio, Alejandro
A1 San Juan Garrido, Rafael
A1 García-Reyne, Ana
A1 López Medrano, Francisco
A1 Lizasoaín Hernández, Manuel
A1 De Dios, Begoña
A1 Andrés Belmonte, Amado
A1 Jiménez, Carlos
A1 Gutiérrez Rivas, Eduardo José
A1 Moreno González, Enrique
A1 Aguado García, José María
AB Limited information exists about epidemiology and risk factors of infection following pancreas-kidney transplantation and its impact on long-term pancreatic graft function. A retrospective chart review of episodes of severe infection in consecutive pancreas-kidney transplantations in a single institution was performed to assess the epidemiology, risk factors for infection and their impact on the development of pancreatic graft dysfunction. Ninety-four (81%) of 116 recipients (median follow-up of 1492 days; mean 1594) developed 248 episodes of severe infection. Bacterial infections were present in 208 episodes, with 12% of the isolates resistant to antibiotics used in prophylaxis. There were 40 episodes of fungal infection in 32 patients (28%) (mostly Candida spp), and CMV disease appeared in 20 patients (17%), of which 50% appeared after the third month following surgery. The multivariate analysis identified that surgical re-intervention and the use of steroid pulses were independently associated with the development of any infection. Additionally, pre-transplant evidence of peripheral artery disease, a longer cold ischaemia time and high transfusional requirements were associated with fungal infections. Cytomegalovirus (CMV) mismatch was independently related to CMV disease and female sex, and bladder drainage of the exocrine pancreas was associated with urinary tract infection. At the end of follow-up, 29 patients (25%) had developed severe pancreatic graft dysfunction, and fungal infection was independently associated with it. Our study identifies a subset of pancreas-kidney transplant recipients at a higher risk of developing severe infection. Fungal infection is an independent risk factor for the development of severe pancreatic graft dysfunction.
PB Elsevier
SN 1198-743X
YR 2013
FD 2013
LK https://hdl.handle.net/20.500.14352/116623
UL https://hdl.handle.net/20.500.14352/116623
LA eng
NO J M Herrero-Martínez 1, C Lumbreras, A Manrique, R San-Juan, A García-Reyne, F López-Medrano, M Lizasoain, B de Dios, A Andrés, C Jiménez, E Gutiérrez, E Moreno, J M Aguado. Clin Microbiol Infect . 2013 Dec;19(12):1132-9.
NO Fundación Mutua Madrileña
NO Red Española de Investigación en Patología Infecciosa
DS Docta Complutense
RD 6 abr 2025