Types of infectious complications exciters in recipients of related kidneys

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Aim. To investigate the nature of microflora causing an infectious-inflammatory complications in recipients of related kidney in the early postoperative period and to substantiate the effectiveness of antibiotic prophylaxis and antibiotic therapy depending on pathogen type with the determination of its sensitivity to antimicrobial agents. Material and methods. The medical records of 255 patients who underwent kidney transplantation from a living related donor from 2007 to 2014 were analyzed. Foci of infection were sanitized preoperatively to prevent infectious complications in post-transplantation period. Immunosuppression induction was achieved using 2-fold administration of Kempas or Simulect. Corticosteroids, ciclosporin, prograf, advagraf, myfortic, neoral, sertican were used for routine immunosuppression. Complications after kidney transplantation were detected in 65 (25.5%) patients including 38 (14.9%) infectious and 27 (10.6%) non-infectious complications. The material for microbiological examination included blood, urine, sputum, wound discharge, bronchial lavage. Extraction and identification of microorganisms were carried out according to conventional techniques as well as using automatic Vitec-2 Compact analizer («BioMeriex», France). Sensitivity to antibiotics was determined using Vitek-2 Compact analyzer. The functional aspects of transplanted kidney were studied in 255 patients. Normal and decreased function of kidney was observed in 221 (86.6%) and 30 (11.8%) cases respectively. Transplantant did not function in 4 (1.57%) patients. Results. The probability of infection is highest in the early postoperative period. Risk factors were inadequate and prolonged antibiotic therapy, unrecognized infection postoperatively. The main problem in renal transplant recipients is urinary tract infection (90% of patients).

Keywords:

related kidney transplantation

immunosupressive therapy

infectious complications

Authors:

Volynchik E.P.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

Bogomolova N.S.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo, RAMN, Moskva

Goriaĭnov V.A.

Otdelenie transplantatsii pochki Rossiĭskogo nauchnogo tsentra khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

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