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To improve our understanding of posttransplant infections, we analyzed bacterial, viral, fungal, parasitic, and other infections in 604 consecutive recipients of kidney (n = 518), kidney-pancreas (n = 82), kidney-liver (n = 3), or kidney-islet (n = 1) allografts (355 cadaveric, 14 living-unrelated, 235 living-related donors) who also received cyclosporine, azathioprine, and prednisone immunosuppression. Recipients of cadaveric grafts received additional induction immunosuppression (antilymphocyte globulin or murine monoclonal antibody OKT3). Rejection episodes were treated with high-dose steroids, and either antilymphocyte globulin or OKT3 was administered when clinically indicated. Perioperative antibiotics and posttransplant prophylactic acyclovir sodium or ganciclovir sodium, trimethoprim-sulfamethoxazole, and clotrimazole or nystatin (Mycostatin) were administered to all recipients. Two hundred thirteen patients (35.3%) were found to have had no identifiable infections, while 391 (64.7%) had either isolated bacterial (97 [16.1%]), viral (53 [8.8%]), or fungal (34 [5.6%]) infections or combination (concurrent or sequential) infections with bacterial plus viral (46 [7.6%]), bacterial plus fungal (66 [10.9%]), viral plus fungal (20 [3.3%]), bacterial plus viral plus fungal (64 [10.6%]), or bacterial plus viral plus fungal plus parasitic (11 [1.8%]) pathogens in the posttransplantation period. Renal allograft survival (percentage, actuarial method) was diminished in patients with infections at both 1 year (91% vs 83%) and 3 years (81% vs 76%) after transplantation, as was actuarial patient survival (1 year, 97% vs 92%; 3 years, 93% vs 88%). We conclude that infection remains a major cause of both patient demise and allograft loss following successful solid-organ transplantation.
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
December 2014,
Clinical and experimental immunology,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
January 2007,
Seminars in roentgenology,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
January 2019,
Critical care clinics,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
December 2003,
Pediatric clinics of North America,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
August 2000,
Clinical transplantation,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
January 1992,
Advances in pediatric infectious diseases,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
January 2009,
Journal of intensive care medicine,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
November 2023,
La Revue du praticien,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
April 2010,
Pediatric clinics of North America,
K L Brayman, and
E Stephanian, and
A J Matas, and
W Schmidt, and
W D Payne, and
D E Sutherland, and
P F Gores, and
J S Najarian, and
D L Dunn
April 2015,
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation,
