Risk factors evaluation of invasive fungal infection after kidney transplantation / 中华肾脏病杂志

ABSTRACT

Objective To explore the risk factors of invasive fungal infection after kidney transplantation and to evaluate their effect on prognosis. Methods Data of 2573 patients of kidney transplantation in our center from Jan 1994 to May 2008 were analyzed retrospectively. Patients were divided into case group and control group according to fungal infection after operation. Differences of age, preoperative conditions, complications after operation, drainage time, application of broad-spectrum antibiotics, and use of anti-rejection drugs were compared between these two groups to identify the risk factors of postoperative fungal infection. The impact of risk factor amount on the incidence and mortality of invasive fungal infection, as well as on the mortality of patients and graft loss rate was analyzed. Results Compared with control group, the number of aged patients elevated significantly, as well as the incidence of delayed graft function (DGF), acute rejection, CMV infection, liver function impairment, delayed incision healing, and myelosuppression went up significantly in case group. The incidence of long drainage time (>1 week), using broad-spectrum antibiotics (>1 week) and anti-rejection drugs was also increased in case group (P<0.01) . Multivariate Logistic regression showed that aging (≥60 years), DGF, delayed incision healing, myelosurppression, and using broad-spectrum antibiotics (>1 week) were independent risk factors for invasive fungal infection. With the risk factor number increasing, the incidence and mortality increased significantly (X2=91.2 and 18.1 ,respectively, P<0.01), the graft loss rate also increased significantly (X2=93.0, P<0.01). Conclusion Evaluaton of risk factors and prevention of fungal infection after kidney transplantation are very important for improving the prognosis.