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Donor positive blood culture is associated with delayed graft function in kidney transplant recipients: a propensity score analysis of the UNOS database
Author(s) -
Huaman Moises A.,
Vilchez Valery,
Mei Xiaonan,
Davenport Daniel,
Gedaly Roberto
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12703
Subject(s) - medicine , propensity score matching , dialysis , cohort , proportional hazards model , kidney transplantation , logistic regression , retrospective cohort study , transplantation , kidney , renal function , survival analysis , cohort study , surgery , urology , database , computer science
Background The effect of blood culture positive donor ( BCPD ) on delayed graft function ( DGF ) in kidney transplant recipients has not been well established. Methods We retrieved data from the United Network for Organ Sharing ( UNOS ) registry on all adults who underwent primary, single organ deceased‐donor kidney transplantation in US between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non‐ BCPD cohort. We used propensity scores for 1:1 matching of BCPD and non‐ BCPD cohorts. DGF , graft and patient survival at one yr were compared between cohorts using multivariable logistic and Cox regression models. DGF was defined as requiring dialysis within the first week post‐transplant. Results There were 4126 (8.1%) recipients of BCPD during the study period. DGF was associated with BCPD ( aOR ; 1.15, 95% CI 1.07–1.24). This association was maintained in the propensity‐score matched analysis (p < 0.01). No association was found between BCPD and graft survival ( aHR ; 1.01, 95% CI , 0.92–1.09) or patient survival ( aHR ; 0.92, 95% CI , 0.82–1.04). Conclusion Blood culture positive donor was associated with DGF but did not impact graft or patient survival in deceased‐donor kidney transplants. This suggests a transient negative effect of BCPD that does not appear to translate into a more persistent deleterious outcome.