Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes
(1) Background: Little is known about the subsequent renal function change following incident infectious diseases in living-donor liver transplant (LT) recipients. (2) Methods: We studied patients who underwent living-donor LT from January 2003 to January 2019 to evaluate the association of incident...
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MDPI AG
2022-09-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/17/3660 |
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| author | Kao-Ming Hsu Pei-Ru Lin Ping-Fang Chiu Yao-Peng Hsieh |
| author_facet | Kao-Ming Hsu Pei-Ru Lin Ping-Fang Chiu Yao-Peng Hsieh |
| author_sort | Kao-Ming Hsu |
| collection | DOAJ |
| description | (1) Background: Little is known about the subsequent renal function change following incident infectious diseases in living-donor liver transplant (LT) recipients. (2) Methods: We studied patients who underwent living-donor LT from January 2003 to January 2019 to evaluate the association of incident hospitalization with major infections or pneumonia with adverse renal outcomes, including a sustained 40% reduction in estimated glomerular filtration rate (eGFR) and renal composite outcome (a 40% decline in eGFR, end-stage renal disease, or death.). Multivariable-adjusted time-dependent Cox models with infection as a time-varying exposure were used to estimate hazard ratio (HR) with 95% confidence interval (CI) for study outcomes. (3) Results: We identified 435 patients (mean age 54.6 ± 8.4 years and 76.3% men), of whom 102 had hospitalization with major infections during follow-up; the most common cause of infection was pneumonia (38.2%). In multiple Cox models, hospitalization with a major infection was associated with an increased risk of eGFR decline > 40% (HR, 3.32; 95% CI 2.13–5.16) and renal composite outcome (HR, 3.41; 95% CI 2.40–5.24). Likewise, pneumonia was also associated with an increased risk of eGFR decline > 40% (HR, 2.47; 95% CI 1.10–5.56) and renal composite outcome (HR, 4.37; 95% CI 2.39–8.02). (4) Conclusions: Our results illustrated the impact of a single infection episode on the future risk of adverse renal events in LT recipients. Whether preventive and prophylactic care bundles against infection and judicious modification of the immunosuppressive regimen benefit renal outcomes may deserve further study. |
| first_indexed | 2024-03-10T01:24:07Z |
| format | Article |
| id | doaj.art-a398fe3c526642bc8157ad54b0a16a23 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T01:24:07Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-a398fe3c526642bc8157ad54b0a16a232023-11-23T13:54:13ZengMDPI AGNutrients2072-66432022-09-011417366010.3390/nu14173660Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal OutcomesKao-Ming Hsu0Pei-Ru Lin1Ping-Fang Chiu2Yao-Peng Hsieh3Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 50006, TaiwanBig Data Center, Changhua Christian Hospital, Changhua 50006, TaiwanDivision of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 50006, TaiwanDivision of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan(1) Background: Little is known about the subsequent renal function change following incident infectious diseases in living-donor liver transplant (LT) recipients. (2) Methods: We studied patients who underwent living-donor LT from January 2003 to January 2019 to evaluate the association of incident hospitalization with major infections or pneumonia with adverse renal outcomes, including a sustained 40% reduction in estimated glomerular filtration rate (eGFR) and renal composite outcome (a 40% decline in eGFR, end-stage renal disease, or death.). Multivariable-adjusted time-dependent Cox models with infection as a time-varying exposure were used to estimate hazard ratio (HR) with 95% confidence interval (CI) for study outcomes. (3) Results: We identified 435 patients (mean age 54.6 ± 8.4 years and 76.3% men), of whom 102 had hospitalization with major infections during follow-up; the most common cause of infection was pneumonia (38.2%). In multiple Cox models, hospitalization with a major infection was associated with an increased risk of eGFR decline > 40% (HR, 3.32; 95% CI 2.13–5.16) and renal composite outcome (HR, 3.41; 95% CI 2.40–5.24). Likewise, pneumonia was also associated with an increased risk of eGFR decline > 40% (HR, 2.47; 95% CI 1.10–5.56) and renal composite outcome (HR, 4.37; 95% CI 2.39–8.02). (4) Conclusions: Our results illustrated the impact of a single infection episode on the future risk of adverse renal events in LT recipients. Whether preventive and prophylactic care bundles against infection and judicious modification of the immunosuppressive regimen benefit renal outcomes may deserve further study.https://www.mdpi.com/2072-6643/14/17/3660chronic kidney diseaseinfectionliver transplantationpneumonia |
| spellingShingle | Kao-Ming Hsu Pei-Ru Lin Ping-Fang Chiu Yao-Peng Hsieh Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes Nutrients chronic kidney disease infection liver transplantation pneumonia |
| title | Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes |
| title_full | Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes |
| title_fullStr | Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes |
| title_full_unstemmed | Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes |
| title_short | Infection in Living Donor Liver Transplantation Leads to Increased Risk of Adverse Renal Outcomes |
| title_sort | infection in living donor liver transplantation leads to increased risk of adverse renal outcomes |
| topic | chronic kidney disease infection liver transplantation pneumonia |
| url | https://www.mdpi.com/2072-6643/14/17/3660 |
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