Experience in the treatment of a primary infected kidney transplant
https://doi.org/10.23873/2074-0506-2023-15-2-216-225
Abstract
Introduction. Infectious complications contribute to a significant decrease in graft and recipient survival rates. The article describes a case report of transplantation of the primary infected kidney transplant.
Material and methods. A 33-year-old patient with type 1 diabetes mellitus and end-stage renal disease underwent kidney transplantation. The deceased donor was a 46-year-old man with a confirmed brain death as a result of acute cerebrovascular accident.
Results. The early postoperative period was complicated by the development of primary infection of kidney transplant. Despite the ongoing treatment aimed at preserving the transplant, we had to remove it in order to prevent the development of further complications.
Conclusion. Kidney transplantation improves the quality of life of patients with end-stage renal disease. In case of uncontrolled course of the infectious process after primary infected graft transplantation, it is necessary to perform transplantectomy in a timely manner in order to save the recipient’s life, since the graft itself is the source of infection.
About the Authors
M. Sh. KhubutiyaRussian Federation
Mogeli Sh. Khubutiya, Academician of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.), President; Head of the Department of Transplantology and Artificial Organs
10%, design development, making conclusions, approval of the final version of the article
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
20 Bldg. 1 Delegatskaya St., Moscow 127473;
D. V. Lonshakov
Russian Federation
Denis V. Lonshakov, Surgeon of the Department of Kidney and Pancreas Transplantation,
20%, design development, clinical part, making of conclusions, technical editing
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
A. G. Balkarov
Russian Federation
Aslan G. Balkarov, Cand. Sci. (Med.), Head of the Scientific Department of Kidney and Pancreas Transplantation, N.V. Sklifosovsky Research Institute for Emergency Medicine; Associate Professor of the Department of Transplantology and Artificial Organs N.I. Pirogov Russian National Research Medical University; Head of the Organizational and Methodological Department for Transplantology, Research Institute for Healthcare Organization and Medical Management,
10%, design development, clinical part, making conclusions, technical editing, approval of the final version of the article
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
1 Ostrovityanov St., Moscow 117997;
30 Bolshaya Tatarskaya St., 30 Moscow 115184
Yu. A. Anisimov
Russian Federation
Yuriy A. Anisimov, Cand. Sci. (Med.), Surgeon, Department of Kidney and Pancreas Transplantation; Senior Laboratory Assistant, the Department of Transplantology and Artificial Organs
10%, design development, literature review, making conclusions, technical editing
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
20 Bldg. 1 Delegatskaya St., Moscow 127473;
N. V. Shmarina
Russian Federation
Nonna V. Shmarina, Cand. Sci. (Med.), Senior Researcher of the Department of Kidney and Pancreas Transplantation; Associate Professor of the Department of Transplantology and Artificial Organs,
10%, design development, clinical part, making conclusions
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
1 Ostrovityanov St., Moscow 117997;
N. V. Zagorodnikova
Russian Federation
Natalya V. Zagorodnikova, Cand. Sci. (Med.), Nephrologist of the Department of Kidney and Pancreas Transplantation,
10%, design development, clinical part
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
V. O. Aleksandrova
Russian Federation
Veronika O. Aleksandrova, Surgeon of the Department of Kidney and Pancreas Transplantation,
10%, design development, clinical part
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
I. V. Dmitriev
Russian Federation
Ilya V. Dmitriev, Cand. Sci. (Med.), Head of the Department of Kidney and Pancreas Transplantation; Associate Professor of the Department of Transplantology and Artificial Organs,
20%, design development, literature review, clinical part, making conclusions, technical editing, approval of the final version of the article
3 Bolshaya Sukharevskaya Sq., Moscow 129090;
1 Ostrovityanov St., Moscow 117997;
References
1. Knechtle SJ, Morris P. Kidney transplantation – principles and practice: expert consult. 7th ed. Saunders; 2013.
2. Bozkurt B, Kumru AÖ, Dumlu EG, Tokaç M, Koçak H, Süleymanlar G, et al. Patient and graft survival after preemptive versus non-pre-emptive kidney transplantation: a single-center experience from Turkey. Transplantat Proc. 2013;45(3):932–934. PMID: 23622591 https://doi.org/10.1016/j.transproceed.2013.02.064
3. Hariharan S, Israni AK, Danovitch G. Long-term survival after kidney transplantation. N Engl J Med. 2021;385(8):729–743. PMID: 34407344 https://doi.org/10.1056/NEJMra2014530
4. Wang JH, Skeans MA, Israni AK. Current status of kidney transplant outcomes: dying to survive. Adv Chronic Kidney Dis. 2016;23(5):281–286. PMID: 27742381 https://doi.org/10.1053/j.ackd.2016.07.001
5. Ferna´ndez-Fresnedo G, Rodrigo E, Escallada R, de Francisco ALM, Zubimendi JA, Ruiz JC, et al. Effect of early graft function on patient survival in renal transplantation. Transplant Proc. 2003;35(5):1653–1654. PMID: 12962744 https://doi.org/10.1016/s0041-1345(03)00615-8
6. Harada KM, Mandia-Sampaio EL, de Sandes-Freitas TV, Felipe CR, Park SI, Pinheiro-Machado PG, et al. Risk factors associated with graft loss and patient survival after kidney transplantation. Transplant Proc. 2009;41(9):3667–3670. PMID: 19917364 https://doi.org/10.1016/j.transproceed.2009.04.013
7. Masutani K. Viral infections directly involved in kidney allograft function. Nephrology (Carlton). 2018;23(Suppl 2):31–37. PMID: 29968408 https://doi.org/10.1111/nep.13285
8. Epidemiology of kidney disease in the United States. 2022 USRDS Annual Data Report National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://usrds-adr.niddk.nih.gov/2022 [Accessed March 1, 2023].
9. Battaglia M, Ditonno P, Selvaggio O, Garofalo L, Palazzo S, Schena A, et al. Kidney transplants from infected donors: our experience. Transplant Proc. 2004;36(3):491–492. PMID: 15110567 https://doi.org/10.1016/j.transproceed.2004.02.009
10. Ison MG, Grossi P. Donor-derived infections in solid organ transplantation. Am J Transplant. 2013;(Suppl 4):22–30. PMID: 23464995 https://doi.org/10.1111/ajt.12095
11. Singh N. Impact of donor bacteremia on outcome in organ transplant recipients. Liver Transpl. 2002;8(10):975–976. PMID: 12360445 https://doi.org/10.1053/jlts.2002.0080975
12. Pérez-Granados EE, Díaz-Chávez E, Álvarez JA, Macías AE, Arreguín V, Gutiérrez-Canales LG, et al. Impact of infections and extended-spectrum betalactamase (ESBL)-producing Enterobacteriaceae on graft and patient survival in a kidney transplantation program in Mexico. Gac Med Mex. 2022;158(5):295–301. PMID: 36572033 https://doi.org/10.24875/GMM.M22000698
13. Veroux M, Corona D, Scriffignano V, Caglià P, Gagliano M, Giuffrida G, et al. Contamination of preservation fluid in kidney transplantation: single-center analysis. Transplant Proc. 2010;42(4):1043–1045. PMID: 20534219 https://doi.org/10.1016/j.transproceed.2010.03.041
14. Zhang F, Zhong J, Ding H, Liao G. Effects of preservative fluid associated possible donor-derived carbapenemresistant Klebsiella Pneumoniae infection on kidney transplantation recipients. BMC Nephrol. 2022;23(1):101. PMID: 35287599 https://doi.org/10.1186/s12882-022-02733-7
Review
For citations:
Khubutiya M.Sh., Lonshakov D.V., Balkarov A.G., Anisimov Yu.A., Shmarina N.V., Zagorodnikova N.V., Aleksandrova V.O., Dmitriev I.V. Experience in the treatment of a primary infected kidney transplant. Transplantologiya. The Russian Journal of Transplantation. 2023;15(2):216-225. https://doi.org/10.23873/2074-0506-2023-15-2-216-225