Impact of Repeated Non-Fatal Infections on Quality of Life and Graft Function in ABO-Incompatible Kidney Transplants.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2025-07-22 DOI:10.1111/tid.70084

Federica Bocchi, Isabelle Binet, Dela Golshayan, Fadi Haidar, Cédric Hirzel, Thomas Müller, Thomas Schachtner, Daniel Sidler

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引用次数: 0

Abstract

Background: Kidney transplantation (KT) is the preferred treatment for kidney failure, with living donor KT (LDKT) offering better outcomes and improved quality of life (QOL) than deceased donor KT. ABO incompatibility (ABOi) once restricted LDKT, but desensitization protocols now enable ABOi LDKT, expanding the donor pool with favorable outcomes. However, added risks of ABOi remain debated. We examined the impact of repeated infections on graft loss and death in both ABO-compatible (ABOc) and ABOi LDKT recipients.

Methods: Retrospective, nationwide Swiss Transplant Cohort Study from May 2008 to December 2022, including all ABOi LDKT patients. Clinically relevant infections (viral, bacterial, fungal, and parasitic) were analyzed as repeated adverse events.

Results: Among 227 ABOi LDKT and 1172 ABOc recipients, 13% (183/1399) had ≥ 2 significant infections within the first 6 months. ABOi was independently associated to a higher infection risk (HR 1.21, 95% CI 1.10-1.34, p < 0.001). Patients with early recurrent infections were older, often female, and had ABOi LDKT. Patients with ≥ 2 infections faced increased risks of graft loss, lower eGFR, and reduced QOL.

Conclusion: ABOi LDKT patients face a higher risk of recurrent infections, especially within 6 months post-KT, associated with reduced allograft function and lower QOL.

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反复非致死性感染对abo血型不相容肾移植患者生活质量和移植物功能的影响。

背景：肾移植（KT）是肾衰竭的首选治疗方法，活体肾移植（LDKT）比已故肾移植提供更好的预后和改善的生活质量（QOL）。ABO不相容性（ABOi）一度限制了LDKT，但脱敏方案现在使ABOi LDKT成为可能，扩大了供体库，并取得了良好的结果。然而，ABOi的附加风险仍存在争议。我们研究了abo相容（ABOc）和ABOi LDKT受体中反复感染对移植物丢失和死亡的影响。方法：2008年5月至2022年12月，瑞士全国移植队列研究，包括所有ABOi LDKT患者。临床相关感染（病毒、细菌、真菌和寄生虫）作为重复不良事件进行分析。结果：227例ABOi LDKT和1172例ABOc受者中，13%（183/1399）在前6个月内出现≥2次显著感染。ABOi与较高的感染风险独立相关（HR 1.21, 95% CI 1.10-1.34, p）。结论：ABOi LDKT患者面临较高的复发感染风险，特别是在kt后6个月内，与同种异体移植功能降低和较低的生活质量相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.