Korean J Transplant.  2022 Nov;36(Supple 1):S318. 10.4285/ATW2022.F-4554.

Short-term safety of carbapenem-resistant enterobacteriaceae colonized donor on deceased donor kidney transplantation

• Youn S
• Cho H
• Park M
• Kim M
• Hwang J
• Lim J
• Choi BS
• Ban TH

• KMID: 2535545
• DOI: http://doi.org/10.4285/ATW2022.F-4554

Abstract

Donor-derived infection has been an important issue in kidney transplantation (KT). Here we report cases of deceased donor kidney transplantation (DDKT) from a single donor with carbapenem-resistant enterobacteriaceae (CRE) to two different recipients. A 44-year-old woman was hospitalized due to mental change. Owing to dyspnea and severe metabolic acidosis, she was applied ventilator and continuous renal replacement therapy. On hospital day 5, she was diagnosed as brain death. Before organ donation, incidentally, CRE was confirmed in her sputum and rectal culture, but it was not observed in blood or urine culture. First recipient, a 63-year-old woman on hemodialysis, underwent DDKT. The patient complained of urinary symptom on postoperative day 5. Urine culture was performed and pseudomonas aeruginosa was identified. Ceftazidime was applied for 7days, and the follow-up urine culture showed no growth. She had no infectious complication until 5 months after transplanta-tion. At that time, graft failure occurred and she restarted hemodialysis. Second recipient, a 67-year-old man on hemodialysis, underwent DDKT. He had repeatedly suffered from pneumonia and hemoptysis because of nontuberculous mycobacteria infection after transplantation. Five months after transplantation, unexpectedly, he was newly diagnosed as bile duct cancer. He had been performed pylorus preserving pancreatoduodectomy and concomitant chemoradiotherapy, but expired 19 months after transplantation. Both of two recipients had never experienced CRE infection during the follow-up period. Therefore, for a short period after transplantation, CRE identified from sources other than blood or urine may not transmit to recipient and may not cause infectious complications.