ABSTRACT
Background: Delayed graft function (DGF) among deceased donor kidney transplant recipients (DDKTRs) is a well-known risk factor for allograft rejection, decreased graft survival, and increased cost. Although DGF is associated with an increased risk of rejection, it is unclear whether it also increases the risk of infection. Methods: We reviewed all adult DDKTRs at our center between 2010 and 2018. The primary outcomes of interest were BK viremia, cytomegalovirus viremia, pneumonia, and urinary tract infection (UTI) within the first year of transplant. Additional analysis was made with censoring follow-up at the time of allograft rejection. Results: A total of 1512 DDKTRs were included, of whom 468 (31%) had DGF. As expected, several recipient, donor, and baseline immunological characteristics differed by DGF status. After adjustment, DGF was significantly associated with an increased risk of BK viremia (hazard ratio: 1.34; 95% confidence interval, 1.0-1.81; P = 0.049) and UTI (hazard ratio: 1.70; 95% confidence interval, 1.31-2.19; P < 0.001) but not cytomegalovirus viremia or pneumonia. Associations were similar in models censored at the time of rejection. Conclusions: DGF is associated with an increased risk of early infectious complications, mainly UTI and BK viremia. Close monitoring and appropriate management are warranted for better outcomes in this unique population.
ABSTRACT
When patients are diagnosed or concerned with the diagnosis of melanoma, they commonly use the Internet for information. We assessed the content of patient-focused websites about melanoma. We searched for "melanoma" in four search engines then assessed the first 30 websites in each search. Among included sites, we describe potentially useful content about melanoma: website quality, readability, popularity, and social media sharing. In 31 included websites, > 80% mentioned the definition and risk factors for melanoma, when to seek medical help, how to diagnose, and treatment options, and > 70% described preventive measures. However, website quality was variable: 61% of websites had disclosures, 54% were dated, 41% had a clear author, and 41% had references. Average readability ranged from 8th to 12th grade, which is above recommended reading levels for patient websites. Despite this variation and high reading levels, we identified many high-quality melanoma websites for patients.