scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2019 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 23%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2020 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 21%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals COVID-19 Infection in Kidney Transplant Recipients: Disease Incidence and Clinical Outcomes

2020 ◽  
Vol 31 (10) ◽  
pp. 2413-2423 ◽  
Author(s):  
Michelle Elias ◽  
Daniele Pievani ◽  
Christine Randoux ◽  
Kevin Louis ◽  
Blandine Denis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Disease ◽  
Kidney Transplant ◽  
Disease Incidence ◽  
High Morbidity ◽  
Chronic Pulmonary Disease ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
White Ethnicity

BackgroundCOVID-19 has been associated with high morbidity and mortality in kidney transplant recipients. However, risk factors for COVID-19 disease in patients with kidney transplants remain poorly defined.MethodsWe enrolled patients who underwent kidney transplantation and were actively followed up in two hospitals in Paris on March 1st, 2020. Patients were screened for baseline and transplant characteristics, functional parameters, comorbidities, and immunosuppressive therapies. COVID-19 disease was assessed. Patients were followed up during the pandemic until April 30th, 2020 by the COVID-19 SLS KT survey program, including teleconsulting, at-home monitoring for patients with COVID-19, and a dedicated phone hotline platform.ResultsAmong 1216 patients with kidney transplants enrolled, 66 (5%) patients were identified with COVID-19 disease, which is higher than the incidence observed in the general population in France (0.3%). Their mean age was 56.4±12.5 years, and 37 (56%) patients were men. The following factors were independently associated with COVID-19 disease: non-White ethnicity (adjusted odds ratio [OR], 2.17; 95% confidence interval [95% CI], 1.23 to 3.78; P=0.007), obesity (OR, 2.19; 95% CI, 1.19 to 4.05; P=0.01), asthma and chronic pulmonary disease (OR, 3.09; 95% CI, 1.49 to 6.41; P=0.002), and diabetes (OR, 3.33; 95% CI, 1.92 to 5.77; P<0.001). The mortality rate related to COVID-19 disease was 1% in the overall study population and 24% in COVID-19–positive patients.ConclusionsPatients with kidney transplants display a high risk of mortality. Non-White ethnicity and comorbidities such as obesity, diabetes, asthma, and chronic pulmonary disease were associated with higher risk of developing COVID-19 disease. It is imperative that policy makers urgently ensure the integration of such risk factors on response operations against COVID-19.

Delayed graft function in kidney transplant recipients: risk factors and short-term outcome

2002 ◽  
Vol 34 (1) ◽  
pp. 352-354 ◽  
Author(s):  
R.A Iglesias-Márquez ◽  
E.A Santiago-Delpı́n ◽  
E Zayas ◽  
Z González-Caraballo ◽  
L Morales-Otero
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

scholarly journals Frequency and Risk Factors of Purulent Septic Infection among Adults after Different Types of an Open Heart Operations

2020 ◽  
Vol 19 (5) ◽  
pp. 34-40
Author(s):  
V. I. Sergevnin ◽  
L. G. Kudryavtseva ◽  
A. I. Zolotukhina
Keyword(s):  
Risk Factors ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Aortic Surgery ◽  
Open Heart Surgery ◽  
Incidence Rates ◽  
Open Heart ◽  
Hospital Acquired Pneumonia ◽  
Definition Of ◽  
Hospital Acquired

Relevance. The problem of purulent postoperative septic infection (the hospital acquired infection or HAI) is still one of the main cause of fatal outcomes of patients in cardiac hospitals, which demands significant material costs. The aim of the work is to evaluate the intensity of the epidemic process and risk factors for HAI among adults after various types of open heart surgery.Materials and methods. The study of medical records of 1540 patients over 18 years old, who underwent open heart surgery for the purpose of coronary artery bypass grafting (CABG), prosthetics of valves and elimination of aortic defects, was held. Typical and donozological forms of HAI were taken into account in accordance with the epidemiological standard definition of cases.Results. The incidence rates of typical and donozological forms of HAI in average was 39.6 and 72.7 per 1000 operations. The maximum incidence of HAI was detected after aortic surgery due to urinary tract infection (UTI) and hospital-acquired pneumonia.Conclusions. It was found that the increased incidence of UTI and hospital-acquired pneumonia after aortic surgery is contingent on a longer cardiosurgical operations and, accordingly, a longer stay of patients in the Department of anesthesia and resuscitation, accompanied by artificial ventilation and catheterization of the bladder, than in other cardiac operations

Risk Factors for Late-Onset Cytomegalovirus Infection or Disease in Kidney Transplant Recipients

2014 ◽  
Vol 97 (5) ◽  
pp. 569-575 ◽  
Author(s):  
Alainna J. Jamal ◽  
Shahid Husain ◽  
Yanhong Li ◽  
Olusegun Famure ◽  
S. Joseph Kim
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Cytomegalovirus Infection ◽  
Late Onset ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Risk factors for colonization and infection by resistant microorganisms in kidney transplant recipients

2021 ◽  
Vol 74 (suppl 6) ◽  
Author(s):  
Monica Taminato ◽  
Richarlisson Borges de Morais ◽  
Dayana Souza Fram ◽  
Rogério Rodrigues Floriano Pereira ◽  
Cibele Grothe Esmanhoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Kidney Transplant ◽  
Multidrug Resistant ◽  
Morbidity And Mortality ◽  
Epidemiological Surveillance ◽  
Resistant Bacteria ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Tract Infections

ABSTRACT Objectives: to assess the prevalence of colonization and infection by multidrug-resistant bacteria in patients undergoing kidney transplantation and identify the rate of infection, morbidity and mortality and associated risk factors. Methods: a prospective cohort of 200 randomly included kidney transplant recipients. Epidemiological surveillance of the studied microorganisms was carried out in the first 24 hours and 7 days after transplantation. Results: ninety (45%) patients were considered colonized. Female sex, hypertension and diabetes (p<0.005), dialysis time (p<0.004), length of stay after transplantation, delayed renal function, and length of stay were identified as risk factors. The microorganisms were isolated from surgical site, bloodstream and urinary tract infections. Conclusions: colonization by resistant microorganisms in kidney transplant patients was frequent and risk factors associated with infection were identified. The results should guide the care team in order to minimize morbidity and mortality related to infectious causes in this population.

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