Infection factors affecting the recovery of kidney function after kidney transplantation and the Countermeasures / 中华器官移植杂志

ABSTRACT

Objective To investigate the influence of infection factors on kidney transplantation after organ donation and possible countermeasures.Methods Thirty-seven cases of kidney transplantation in Organ Transplantation Center of Qianfoshan Hospital Affiliated to Shandong University from January 2014 to December 2016 were retrospectively analyzed.The patients were divided into two groups according to perioperative infection prevention programs42 patients with postoperative routine use of cephalosporins or penicillin for 2 weeks,and 95 patients with postoperative application of carbapenems + micafungin.Postoperative infection rate,occurrence time,pathogen infection;donor age,perioperative pathogens of donor and receptor (organ preservation solution,drainage fluid,urine,sputum samples),acute rejection,delayed graft function (DGF),diabetes mellitus,and the use of immunosuppressive agents were recorded.Results The infection rate in carbapenem + micafungin group was 12.6％,and the infection rate in cephalosporin or penicillin group was 19.4％ (P＜0.05).Pathogen positive detection rate of the drainage fluid,urine and sputum was lower in carbapenems + micafungin group than that in cephalosporins or penicillin (P＜0.05).Within 2 weeks after operation,the detection rate of bacteria and fungi in the carbapenems +micafungin infection prevention group was lower than that in the control group (P＜0.05).There was no significant difference in the detection of viruses (P＞0.05).There were no significant differences in the detection of pathogens among the two weeks to six months after surgery (P＞ 0.05).Donor infection,acute rejection,DGF,and diabetes mellitus were the risk factors for postoperative infection (P＜0.05).Conclusion The application of carbapenems and micafungin can reduce the incidence of infection for the early stage of DCD kidney transplantation.Donor infection,acute rejection,DGF and diabetes mellitus are all risk factors for the postoperative infection.