Infected Kidney Donors Raise Delayed Graft Function Risk

Kidneys from blood culture positive donors are not associated with graft and patient survival, however.
Kidneys from blood culture positive donors are not associated with graft and patient survival, however.

SAN DIEGO—Recipients of kidneys from deceased donors with a clinical infection confirmed by a positive blood culture are at increased risk of delayed graft function (DGF) but not graft loss or death, according to study findings presented at ID Week 2015.

Using the United Network for Organ Sharing database, Moises A. Huaman, MD, MSc, and colleagues at the University of Kentucky in Lexington analyzed data from 51,048 kidney transplant patients, 4,126 of whom received a kidney from a blood culture positive donor (BCPD) and 46,922 who did not.

DGF occurred in 28.4% of the BCPD group versus 25.2% of the non-BCPD group, a significant difference that translated into 15% increased odds of DGF associated with BCPD kidneys in adjusted analyses. The results were similar in a propensity score matching sub-analysis comparing 4,056 BCPD and 4,056 non-BCPD patients. BCPD kidneys were associated with a significant 13% increased odds of DGF. For this analysis, the researchers matched patients by age, sex, history of diabetes, cold ischemia time, and donor creatinine level.

Graft and patient survival at 30 days and 1 year did not differ significantly between the groups.

The researchers defined DGF as the need for renal replacement therapy within the first week after transplantation.

Dr. Huaman's group acknowledged some study limitations, which included a lack of data on specific organisms isolated from cultures. Another possible limitation was selection bias: Transplant teams carefully selected which organs were harvested.

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