The Impact of Culturing the Organ Preservation Fluid on Solid Organ Transplantation: A Prospective Multicenter Cohort Study. (26th April 2019)

• Record Type: Journal Article
• Authors: Oriol, I; Sabe, N; Càmara, J; Berbel, D; Ballesteros, M A; Escudero, R; Lopez-Medrano, F; Linares, L; Len, O; Silva, J T; Oliver, E; Soldevila, L; Pérez-Recio, S; Guillem, L L; Camprubí, D; LLadó, L; Manonelles, A; González-Costello, J; Domínguez, M A; Fariñas, M C; Lavid, N; González-Rico, C; Garcia-Cuello, L; Arnaiz de las Revillas, F; Fortun, J; Aguado, J M; Jimenez-Romero, C; Bodro, M; Almela, M; Paredes, D; Moreno, A; Pérez-Cameo, C; Muñoz-Sanz, A; Blanco-Fernández, G; Cabo-González, J A; García-López, J L; Nuño, E; Carratalà, J;
• Is Part Of: Open forum infectious diseases. Volume 6:Number 6(2019)
• Publication Date: 2019-04-26
• Subjects: preemptive antibiotic therapy -- preservation fluid -- preservation fluid–related infection -- solid organ transplantation; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofz180
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: We analyzed the prevalence, etiology, and risk factors of culture-positive preservation fluid and their impact on the management of solid organ transplant recipients. Methods: From July 2015 to March 2017, 622 episodes of adult solid organ transplants at 7 university hospitals in Spain were prospectively included in the study. Results: The prevalence of culture-positive preservation fluid was 62.5% (389/622). Nevertheless, in only 25.2% (98/389) of the cases were the isolates considered "high risk" for pathogenicity. After applying a multivariate regression analysis, advanced donor age was the main associated factor for having culture-positive preservation fluid for high-risk microorganisms. Preemptive antibiotic therapy was given to 19.8% (77/389) of the cases. The incidence rate of preservation fluid–related infection was 1.3% (5 recipients); none of these patients had received preemptive therapy. Solid organ transplant (SOT) recipients with high-risk culture-positive preservation fluid receiving preemptive antibiotic therapy presented both a lower cumulative incidence of infection and a lower rate of acute rejection and graft loss compared with those who did not have high-risk culture-positive preservation fluid. After adjusting for age, sex, type of transplant, and prior graft rejection, preemptive antibiotic therapy remained a significant protective factor for 90-day infection. Conclusions: The routine culture of preservation fluid may be considered a tool that provides information about the contamination of the transplanted organ. Preemptive therapy for SOT recipients with high-risk culture-positive preservation fluid may be useful to avoid preservation fluid–related infections and improve the outcomes of infection, graft loss, and graft rejection in transplant patients.