scholarly journals 198. Infective Endocarditis Among Solid Organ Transplant Recipients in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S228-S228
Author(s):  
Emily Eichenberger ◽  
Michael M Dagher ◽  
Vance G Fowler ◽  
Jerome Federspiel
Keyword(s):  
United States ◽  
Lower Risk ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Research Support ◽  
History Of ◽  
Research Grant

Abstract Background With over 30,000 solid organ transplants (SOT) performed annually the United States alone, there is an urgent need to understand the risks and outcomes of infective endocarditis (IE) in SOT recipients. Methods We used data from the 2013–2017 Nationwide Readmissions Database (NRD). Hospitalizations associated with IE were identified using diagnosis and procedure codes. The cohort included all patients with IE, stratified by history of solid organ transplant (heart, liver, kidney, lung, intestines, pancreas). Outcomes included 60-day rates of mortality, (extracorporeal membrane oxygenation) ECMO deployment, thromboembolic events, length of stay, and inpatient costs. Regression models, weighted to account for the NRD sample design, were used to model associations between outcomes and transplant history, adjusting for patient age, sex, facility characteristics, comorbid conditions, and potential IE organism. Results A total of 175,682 hospitalizations associated with IE, corresponding to a national estimate of 345,236, were included. Of these, 1,299 (weighted estimate = 2,511) were associated with history of transplant. Transplant recipients were younger (54.2 vs. 59.4 years, p < 0.001), less likely to be female (33.2% vs. 40.1%), had higher rates of renal and liver disease (93.1% vs. 39.2% and 16.2% vs. 8.6%, respectively, p < 0.001 for both). The most common SOT organ (allowing for multiple organs) was kidney (75%) followed by liver (11.5%) and heart (10.5%). Compared to non-SOT patients with IE, SOT recipients with IE were associated with lower risk of mortality [adjusted relative risk (aRR): 0.74, 95% confidence interval (CI) (0.61, 0.89)], lower risk of prolonged mechanical ventilation [aRR 0.80 (0.68, 0.93)], 2.2 fewer inpatient days (-3.5 to -0.8) and $7,000 lower charges (-$9,700, -$4,300), after adjustment. Conclusion IE complicated by SOT history was associated with paradoxically better outcomes than IE in patients without SOT history. The selection process underlying receipt of transplant may partially explain these differences in outcomes. Disclosures Vance G. Fowler, Jr., MD, MHS, Achaogen (Consultant)Actavis (Grant/Research Support)Advanced Liquid Logics (Grant/Research Support)Affinergy (Consultant, Research Grant or Support)Affinium (Consultant)Allergan (Grant/Research Support)Ampliphi Biosciences (Consultant)Basilea (Consultant, Research Grant or Support)Bayer (Consultant)C3J (Consultant)Cerexa (Consultant, Research Grant or Support)Contrafect (Consultant, Research Grant or Support)Cubist (Grant/Research Support)Debiopharm (Consultant)Destiny (Consultant)Durata (Consultant)Forest (Grant/Research Support)Genentech (Consultant, Research Grant or Support)Integrated Biotherapeutics (Consultant)Janssen (Consultant, Research Grant or Support)Karius (Grant/Research Support)Locus (Grant/Research Support)Medical Biosurfaces (Grant/Research Support)Medicines Co. (Consultant)Medimmune (Consultant, Research Grant or Support)Merck (Consultant, Research Grant or Support)NIH (Grant/Research Support)Novadigm (Consultant)Novartis (Consultant, Research Grant or Support)Pfizer (Grant/Research Support)Regeneron (Consultant, Research Grant or Support)Tetraphase (Consultant)Theravance (Consultant, Research Grant or Support)Trius (Consultant)xBiotech (Consultant)

scholarly journals Sebaceous Carcinoma Incidence and Survival Among Solid Organ Transplant Recipients in the United States, 1987-2017

2020 ◽  
Vol 156 (12) ◽  
pp. 1307
Author(s):  
Michael R. Sargen ◽  
Elizabeth K. Cahoon ◽  
Charles F. Lynch ◽  
Margaret A. Tucker ◽  
Alisa M. Goldstein ◽  
...  
Keyword(s):  
United States ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Sebaceous Carcinoma ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

scholarly journals Contribution of solid organ transplant recipients to the pediatric non-hodgkin lymphoma burden in the United States

Cancer ◽  
2017 ◽  
Vol 123 (23) ◽  
pp. 4663-4671 ◽  
Author(s):  
Elizabeth L. Yanik ◽  
Meredith S. Shiels ◽  
Jodi M. Smith ◽  
Christina A. Clarke ◽  
Charles F. Lynch ◽  
...  
Keyword(s):  
United States ◽  
Hodgkin Lymphoma ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Non Hodgkin Lymphoma ◽  
Solid Organ Transplant Recipients

Patient Participation in Research Among Solid Organ Transplant Recipients in the United States

2011 ◽  
Vol 91 (12) ◽  
pp. 1424-1435 ◽  
Author(s):  
Jesse D. Schold ◽  
Laura D. Buccini ◽  
David A. Goldfarb ◽  
Stuart M. Flechner ◽  
Eileen Hsich ◽  
...  
Keyword(s):  
United States ◽  
Patient Participation ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients ◽  
Participation In Research

scholarly journals Earliest cases of coronavirus disease 2019 (COVID‐19) identified in solid organ transplant recipients in the United States

2020 ◽  
Vol 20 (7) ◽  
pp. 1885-1890 ◽  
Author(s):  
Olivia S. Kates ◽  
Cynthia E. Fisher ◽  
Helen C. Stankiewicz‐Karita ◽  
Amanda K. Shepherd ◽  
E. Chandler Church ◽  
...  
Keyword(s):  
United States ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

scholarly journals 2671. Outcomes of Clostridium difficile Infection in Solid-Organ Transplant Patients: Nationwide Inpatient Sample 2015–2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S936-S937
Author(s):  
Rattanaporn Mahatanan ◽  
Prangthip Charoenpong
Keyword(s):  
United States ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Hospital Charges ◽  
Solid Organ ◽  
Total Hospital ◽  
Transplant Patients ◽  
History Of ◽  
Secondary Outcomes

Abstract Background Clostridium difficile infection (CDI) is a leading cause of morbidity and mortality in a hospitalized patient. The incidence and severity of nosocomial CDI have increased significantly since the year 2000. Solid-organ transplant recipients (SOT) are at high risk for CDI for multiple reasons including impaired defense mechanisms from immunosuppression, perioperative antibiotic use, and organ failure. For the past decade, there has been the advance modality of diagnosis and treatments for CDI including early detection of toxin, novel antibiotics, and fecal microbiota transplantation. With the innovative measurements and the effort of antibiotic stewardship, the recent study show improvement of mortality in hospitalized CDI; however, there is still lack of such evidence among SOT patients. Therefore, it would be beneficial to scrutinize the prevalence and outcomes of CDI among SOTs with the most current available nationwide database. Methods Our study utilized the 2015 and 2016 National Inpatient Sample (NIS). It is the largest publicly available all-payer inpatient healthcare database in the United States, yielding national estimates of hospital inpatient stays. Patients with history or undergoing SOT transplant procedure who were hospitalized in 2015 and 2016 NIS database were included in our study. We included heart, lung, liver, intestinal, kidney, pancreas, or at least one of these organs transplanted in our definiton of SOT. History of organ tranplants and CDI were extracted by using ICD-9-CM and ICD-10-CM from discharged diagnosis. Baseline characteristic include age, gender, race, median household income were collected. Confounding includes comorbidities which were calculated into charlson comorbidity index (CCI) and discharge diagnosis of pneumonia and urinary tract infection. Primary outcomes include in-patient mortality, hospital length of stay and total hospital charges. Secondary outcomes include transplant failure or rejection, colectomy and disposition of patients. Multivariable logistic regression was used for the adjusted analysis of the primary and secondary outcomes include all confounders and significant covariates. All reported CIs were two-sided 95% intervals, and tests were done at the two-sided 5% significance level. Stata v14.2 (Stata Corp, College Station, Texas) was utilized for all analyses. Results A total of 107,461 discharges of SOTs in 2015–2016 NIS database were included in our study. The mean age was 53 years (SD 17) and 45,666 (42%) were female. History of kidney transplant was found to be the most common (55%) and history of liver tranplants was the second most common (19%) among our population.The incidence of CDI was 3,626 (3.37%) among SOTs. Factors associated with CDI include age (4% increasing of odds for 10-year increment in age), female (OR 1.2; 95% CI 1.16–1.34), history of heart transplant (OR 1.28; 95% CI 1.11–1.48), kidney transplant (OR 0.98; 95% CI 0.82–0.97), UTI (OR 1.65; 95% CI 1.50–1.81) and pneumonia (OR 1.24;; 95% CI 1.122- 1.38). CDI associated with higher inpatient mortality (OR 1.85, 95% CI 1.56–2.20, P < 0.01), longer length of hospital stay (mean difference 5.07 days, 95% CI 4.43–5.71, P < 0.01) and higher total hospital charges (mean difference 43,958 dollars, P < 0.01). Furthermore, SOTs with CDI had higher risk of transplant complication (OR1.67, 95% CI 1.50–1.87, P < 001) and increase risk of colectomy (OR 2.36, 95% CI 1.50–3.72). Those who had CDI were less likely to be discharged home when compare to non-CDI (OR 0.53, 95% CI 0.49–0.58, P < 0.01). Conclusion Our study found that CDI associated with significant overall worse outcomes among hospitalized solid-organ transplant patients. Multicenter prospective study is considered as a future direction to evaluate the impact to healthcare. Despite the improvement of overall mortality of CDI in general population in the United States from prior study, CDI in SOTs remains problematic. More attention is needed in this particular field. Disclosures All authors: No reported disclosures.

scholarly journals Survival after a cancer diagnosis among solid organ transplant recipients in the United States

Cancer ◽  
2019 ◽  
Vol 125 (6) ◽  
pp. 933-942 ◽  
Author(s):  
Monica E. D’Arcy ◽  
Anna E. Coghill ◽  
Charles F. Lynch ◽  
Lori A. Koch ◽  
Jie Li ◽  
...  
Keyword(s):  
United States ◽  
Cancer Diagnosis ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients
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