腎移植後敗血症與腎衰竭 : 2005年至2014年觀察樣本
許軒豪1、溫玉清1,2、李良明1、林克勳1、林雍偉1,2、蕭志豪1
臺北醫學大學˙市立萬芳醫院泌尿科1、臺北醫學大學泌尿科2
Septicemia and graft failure in kidney transplantation: an observation of
nationwide inpatient sample, during 2005 to 2014
Syuan-Hao Syu1,Yu-Ching Wen1,2,Liang-Ming Lee1,Ke-Hsun Lin1,Yung-Wei Lin1,2,Chi-Hao Hsiao1
Department of Urology, Wan Fang Hospital, Taipei Medical University1
Department of Urology, School of Medicine, College of Medicine, Taipei Medical University2
Purpose: The aim of this study was to identify the risk factors associated with kidney transplant complications and/or graft failure as indicated by the need for dialysis
Materials and Methods: Data from the National Inpatient Sample (NIS) database from 2005 to 2014 were used to identify renal transplant recipients with septicemia (N=14,331). The patients were divided into three groups depending on if they did or did not have posttransplant complication or required dialysis indicative of graft failure.
Results: Multivariate analysis found black race, cytomegalovirus (CMV) or herpes simplex virus (HSV) infection, glomerulonephritis, a history of not being compliant with medication, and hospitalization in an urban teaching or non-teaching hospital were independent risk factors for complications following kidney transplant. Independent risk factors for post-transplant complications and graft failure were black race, CMV or hepatitis C virus (HCV) infection, peripheral vascular disease, coagulopathy, hypertension glomerulonephritis, history of noncompliance, septic shock, and hospitalization in an urban teaching or non-teaching hospital.
Conclusion: Our findings support the use of preventative strategies, both pre- and post-transplantation to prevent post kidney transplant complications and/or the need for dialysis due to infection. In addition, chronic comorbidities should be taken into consideration when managing kidney transplant recipients.