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논문분류	춘계학술대회 초록집
제목	Long term outcomes of post-transplant infections in adult renal transplant recipients
저자	Narayan Prasad, Ruju Gala, Amit Gupta
출판정보	2020; 2020(1):
키워드	Post Transplant Infection \| Graft Survival \| Patient Survival
초록	Infections are a major cause of morbidity in the form of graft loss and mortality in RTR. A number of factors in pre and peri transplant period increase the susceptibility to PTI affecting the overall graft and patient survival. An observational study of 644 adult RTR (=>18yrs) between Jan 2010 and Dec 2015, followed till Jun 2019. Primary objective was to study epidemiology of risk factors of PTI. Secondary objective was to evaluate transplant outcomes. PTI were seen in 83.1%, of which majority (64%) occurred in the first year. Of all infections, 55.5% were bacterial, 18.5% viral, 10.8% parasitic, 8% fungal, and remaining 7.1% mycobacterial. UTI (37.4%) was most common infection with E. Coli (18.9%) being the commonest cause. Relative risk with PTI for graft dysfunction was 4 times higher (p<0.01), graft loss was 3 times higher (p<0.01) and death was 3 times higher (p=0.01) as compared to non PTI. Recurrence of PTI had 2 times higher risk of graft dysfunction (p<0.01) and 3 times higher risk of graft loss (p=0.00). Overall, graft loss was 19.1% and the mortality rate was 12.1% of the study population. The relative risk of fungal infections to cause graft loss was 2 times higher as compared to other infections (95% CI 1.23-2.18, p<0.003). The relative risk of fungal infections to cause death was 2 times higher than other infections (95% CI 1.20-2.56, p <0.008). On multivariate analysis, the predictors of PTI were ATG induction (P<0.01), pre transplant Tuberculosis (P=0.02) and dialysis vintage (P=0.02). On KM survival analysis, graft and patient survival was inferior in PTI at 1,5and 9years; (graft: PTI 94.6%;81.7%;70.3% vs non PTI 98%; 92.2%; 90%, p=0.004, patient: PTI 97.9%;88.2%;81.9% vs non PTI 98.3%; 95.2%; 92.9%, p=0.012) PTI have a significant impact on graft survival and patient survival in RTR.
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