학술논문
Transplantation and immigration: Comparing infectious complications and outcomes between foreign-born and US-born kidney transplant recipients in Minnesota.
Document Type
Academic Journal
Author
Ordaya EE; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.; Shaughnessy M; Department of Medicine, Hennepin HealthCare, Minneapolis, Minnesota, USA.; Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Elkin B; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.; Husmann RL; Department of Medicine, Hennepin HealthCare, Minneapolis, Minnesota, USA.; Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Stauffer JC; School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.; Luengas EM; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Chang BH; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Tessier KM; Masonic Cancer Center, Biostatistics Core, University of Minnesota, Minneapolis, Minnesota, USA.; Walker PF; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; HealthPartners Institute, Minneapolis, Minnesota, USA.; Stauffer WM; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.; School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.; Human Migration and Health, Center for Global Health and Social Responsibility, Minneapolis, Minnesota, USA.
Source
Publisher: Munksgaard Country of Publication: Denmark NLM ID: 100883688 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3062 (Electronic) Linking ISSN: 13982273 NLM ISO Abbreviation: Transpl Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Foreign-born kidney transplant recipients (FBKTRs) are at increased risk for reactivation of latent infections that may impact outcomes. We aimed to compare the etiology of infections and outcomes between FBKTR and United States KTRs (USKTR).
Methods: We performed a retrospective study of patients who underwent kidney transplantation between January 1, 2014 and December 31, 2018 at two transplant centers in Minnesota. Frequency and etiology of infections as well as outcomes (graft function, rejection, and patient survival) at 1-year post-transplant between FBKTR and USKTR were compared.
Results: Of the 573 transplant recipients, 124 (21.6%) were foreign-born and 449 (78.4%) US-born. At least one infection occurred in 411 (71.7%) patients (38.2% bacterial, 55% viral, 9.4% fungal). Viral infections were more frequent in FBKTR, particularly BK viremia (38.7% vs. 21.2%, p < .001). No statistical differences were found for bacterial or fungal infections; no parasitic infections were identified in either group. No geographically-restricted infections were noted aside from a single case of Madura foot in a FBKTR. Rejection episodes were more common in USKTR (p = .037), but stable/improving graft function (p = .976) and mortality (p = .451) at 1-year posttransplantation were similar in both groups. After adjusting for covariates, previous transplantation was associated with a higher number of infections (IRR 1.35, 95% confidence intervals 1.05-1.73, p = .020).
Conclusion: Although viral infections were more frequent in FBKTR, overall frequency and etiology of most infections and outcomes were similar between FBKTR and USKTR suggesting that comprehensive transplant care is providing timely prevention, diagnosis, and treatment of latent infections in FBKTR.
(© 2023 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC.)
Methods: We performed a retrospective study of patients who underwent kidney transplantation between January 1, 2014 and December 31, 2018 at two transplant centers in Minnesota. Frequency and etiology of infections as well as outcomes (graft function, rejection, and patient survival) at 1-year post-transplant between FBKTR and USKTR were compared.
Results: Of the 573 transplant recipients, 124 (21.6%) were foreign-born and 449 (78.4%) US-born. At least one infection occurred in 411 (71.7%) patients (38.2% bacterial, 55% viral, 9.4% fungal). Viral infections were more frequent in FBKTR, particularly BK viremia (38.7% vs. 21.2%, p < .001). No statistical differences were found for bacterial or fungal infections; no parasitic infections were identified in either group. No geographically-restricted infections were noted aside from a single case of Madura foot in a FBKTR. Rejection episodes were more common in USKTR (p = .037), but stable/improving graft function (p = .976) and mortality (p = .451) at 1-year posttransplantation were similar in both groups. After adjusting for covariates, previous transplantation was associated with a higher number of infections (IRR 1.35, 95% confidence intervals 1.05-1.73, p = .020).
Conclusion: Although viral infections were more frequent in FBKTR, overall frequency and etiology of most infections and outcomes were similar between FBKTR and USKTR suggesting that comprehensive transplant care is providing timely prevention, diagnosis, and treatment of latent infections in FBKTR.
(© 2023 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC.)