Document Detail


Causes of death in renal transplant recipients. A review of autopsy findings from 1966 through 1985.
MedLine Citation:
PMID:  3307685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1966 through 1985, a total of 640 patients received 739 renal transplants at a single center transplantation program. Of 245 total deaths, a slide and chart review of all 116 autopsied cases (47%) identified the major causes of death as pneumonia (n = 43), sepsis (n = 32), hemorrhage (n = 15), peritonitis (n = 11), meningitis (n = 7), and pulmonary embolism (n = 5). Eighty-five (73.3%) of these patients died of complications directly associated with immunosuppression, almost all (n = 82) as a result of infection. Organisms most frequently identified at death were gram-negative bacilli (n = 72), Candida species (n = 23), cytomegalovirus (n = 17), enterococcus (n = 14), Staphylococcus aureus (n = 11), Aspergillus species (n = 10), Pneumocystis carinii (n = 5), and mycobacteria (n = 5). Significant associations were found between bolus steroid antirejection therapy and infection with Aspergillus cytomegalovirus. Diabetics had a higher incidence of fungal infections and bowel perforation than nondiabetics. During this 20-year period, overall one-year actual patient survival rates for the four respective five-year intervals increased dramatically (69.9%, 68.2%, 83.3%, and 91.8%), but the normalized death rate showed a smaller decrease for infectious vs noninfectious causes.
Authors:
M W Scroggs; J A Wolfe; R R Bollinger; F Sanfilippo
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  111     ISSN:  0003-9985     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  1987 Oct 
Date Detail:
Created Date:  1987-10-21     Completed Date:  1987-10-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  983-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bacterial Infections / mortality
Child
Diabetes Complications
Female
Humans
Immunosuppression
Kidney Failure, Chronic / surgery*
Kidney Transplantation*
Male
Middle Aged
Mycoses / mortality
Postoperative Complications / mortality*
Grant Support
ID/Acronym/Agency:
AI 19368/AI/NIAID NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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