Premium
Risk factors for infection after pediatric lung transplantation
Author(s) -
Onyearugbulem Chinyere,
Williams Lauren,
Zhu Huirong,
Gazzaneo Maria C.,
Melicoff Ernestina,
Das Shailendra,
CossBu Jorge,
Lam Fong,
Mallory George,
Munoz Flor M.
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13000
Subject(s) - medicine , sepsis , incidence (geometry) , lung transplantation , cystic fibrosis , retrospective cohort study , medical record , risk factor , transplantation , pediatrics , intensive care medicine , physics , optics
Although infection is the leading cause of death in the first year following pediatric lung transplantation, there are limited data on risk factors for early infection. Sepsis remains under‐recognized and under‐reported in the early post‐operative period for lung transplant recipients (LTR). We evaluated the incidence of infection and sepsis, and identified risk factors for infection in the early post‐operative period in pediatric LTRs. A retrospective review of medical records of LTRs at a large quaternary‐care hospital from January 2009 to March 2016 was conducted. Microbiology results on days 0‐7 after transplant were obtained. Sepsis was defined using the 2005 International Pediatric Consensus Conferencecriteria. Risk factors included history of recipient and donor infection, history of multi‐drug resistant (MDR) infection, nutritional status, and surgical times. Among the 98 LTRs, there were 22 (22%) with post‐operative infection. Prolonged donor ischemic time ≥7 hours, cardiopulmonary bypass(CPB) time ≥340 minutes, history of MDR infection and diagnosis of cystic fibrosis were significantly associated with infection. With multivariable regression analysis, only prolonged donor ischemic time remained significant (OR 4.4, 95% CI: 1.34‐14.48). Further research is needed to determine whether processes to reduce donor ischemic time could result in decreased post‐transplant morbidity.