Rates of First Infection Following Kidney Transplant in the United States

This study examined trends and risk factors for post-transplant infections, the second most common cause of death after kidney transplant, in adult kidney transplant patients. Researchers found that the incidence of most infections has changed little since 1995.

With survival rates of a functioning graft beyond the first year also unchanging over the past 20 years, patient management has shifted to management of immunosuppression and complications that may affect long-term graft survival and patient morbidity. In this study, researchers examined trends and risk factors for post-transplant infections in adult kidney transplant patients in the United States. Researchers studied 46,471 adults with Medicare primary coverage at the time of their first kidney transplant, using data from the U.S. Renal Data System (1995-2003).

Key Findings:

  • Bacterial and viral post-transplant infections are most common; fungal and parasitic infections are less common.
  • The most common reasons for infection-caused hospitalizations are UTI in post-transplant year one; pneumonia in years two and three; and sepsis in years one through three.
  • Notable risk factors for post-transplant infections include older age, female sex, diabetes as cause of end-stage renal disease, donor source (deceased versus living), pre-transplant time on dialysis, hepatitis B and C viral pre-transplant serologic status and pre-transplant donor-recipient cytomegalovirus serology.

Despite the identifiable risk factors, the incidence of most post-transplant infections has remained relatively unchanged since 1995.