J Korean Med Sci.  2022 Jan;37(1):e4. 10.3346/jkms.2022.37.e4.

Kidney Transplantation From Deceased Donors With Bloodstream Infection: A Multicenter Retrospective Study

• Mo H
• Lee J
• Park JB
• Park SC
• Kim YH
• Han A
• Jung IM
• Ha J
• Kim NJ
• Min S

• KMID: 2524182
• DOI: http://doi.org/10.3346/jkms.2022.37.e4

Abstract

Background
The use of organs from donors with infection is limited because of the possibility of transmission. We aimed to investigate the transmission after deceased donor transplantation with bloodstream infection (BSI).
Methods
A retrospective study of patients undergoing kidney or pancreas transplantation at five tertiary centers in Korea from January 2009 and November 2019 was performed. We analyzed the outcomes after transplantation from deceased donors with BSI.
Results
Eighty-six recipients received transplantation from 69 donors with BSI. The most common isolated pathogens from donors were Gram-positive bacteria (72.0%), followed by Gram-negative bacteria (22.7%), and fungi (5.3%). Appropriate antimicrobial agents were used in 47.8% of donors before transplantation. Transmission occurred only in 1 of 83 recipients (1.2%) from bacteremic donors and 1 of 6 recipients (16.7%) from fungemic donors. One-year patient and graft survival was 97.5%and 96.3%, respectively. There was no significant difference in graft and patient survival between patients who received organs from infected donors and noninfected donors.
Conclusion
Using organs from donors with bacteremia seems to be a safe option with low transmission risk. The overall prognosis of using organs from donors with BSI is favorable.

Keyword

Retrospective Studies; Bacteremia; Fungi; Kidney Transplantation

Figure

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  Fig. 1 Kaplan-Meier cumulative probability curve showing the incidence of infectious complications after transplantation.

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  Fig. 2 Patient survival (A) and graft survival (B) by donor infection.

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