Significance of pretransplant urinary tract infection in short-term renal allograft function and survival

Transplant Proc. 2008 May;40(4):1117-8. doi: 10.1016/j.transproceed.2008.03.075.

Abstract

Renal transplant recipients are susceptible to postoperative infections, among which those in the urinary tract (UTI) are the most common. We examined the effect of pretransplant bacterial UTI on the incidence of posttransplant UTI as well as complications and short-term outcomes.

Patients and methods: We examined the case records of 100 patients who underwent living-related donor renal transplantation at our institute from November 2006 to June 2007.

Results: Nineteen patients had positive pretransplant bacterial urine cultures and four required native nephrectomy for control of persistent bacterial UTI. All patients were transplanted under a tolerance induction protocol using low-dose immunosuppression after negative suprapubic culture reports. There was no urinary leak/obstruction or vascular complication. The incidence of postoperative bacterial UTI was 31.6% (6 of 19) compared with 6.2% (6 of 81) among patients without pretransplant UTI. E. coli was the most common isolated organism. All patients were doing well with 100% graft survival at 3 months and a mean serum creatinine of 1.27 mg%.

Conclusion: Preoperative UTI predicted an increased likelihood of postoperative UTI without a significant effect on graft/patient survival and graft function.

MeSH terms

  • Adult
  • Aged, 80 and over
  • Bacterial Infections / classification
  • Bacterial Infections / epidemiology
  • Creatinine / blood
  • Diuresis
  • Graft Survival*
  • Humans
  • Kidney Transplantation / mortality
  • Kidney Transplantation / physiology*
  • Living Donors
  • Postoperative Period
  • Preoperative Care*
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Urinary Tract Infections / complications*

Substances

  • Creatinine