Infectious complications in indigenous renal transplant recipients in Western Australia.
BACKGROUND
Infectious complications remain a significant risk following renal transplantation.


AIM
To examine the burden and pattern of infection following renal transplantation in Aboriginal and Torres Strait Islander (ATSI) compared to non-ATSI.


METHODS
A retrospective cohort study of 141 consecutive adult renal transplant recipients in Western Australia between 2005 and 2011 was conducted. We determined baseline serological status for relevant organisms, the number of patients with specific infections, infectious admission in the first year post-transplantation and the rate of infectious death during follow up.


RESULTS
There were 57 ATSI and 84 non-ATSI renal transplant recipients. ATSI compared to non-ATSI had a high rate of cytomegalovirus (CMV) seropositivity (98.2% vs 73.2%, P < 0.001), HBcAb positivity (100% vs 13.3%, P < 0.001) and strongyloides seropositivity (ATSI 3/12 tested). In the first year post-transplant, ATSI compared to non-ASTI had a higher rate of pneumonia (17.9% vs 3.6% of patients, P = 0.006), and non-significant trend to higher rates of gastrointestinal parasitic infection (7.0% vs 1.2% of patients, P = 0.158), invasive fungal infection (10.5% vs 4.8% of patients, P = 0.316), and hospitalisation because of infection (10.0 vs 5.5 days, P = 0.071). Overall 5-year cumulative survival was lower for ATSI versus non-ATSI (0.64 vs 0.86, P = 0.022) with two-thirds of ATSI deaths attributed to infection.


CONCLUSIONS
ATSI are at high risk of infectious complications after renal transplantation associated with a burden of hospitalisation and death. Augmented screening and prophylaxis for infectious diseases should be considered. Further study needs to identify contributing environmental and immunity factors.
['Boan|Peter|P|', 'Swaminathan|Ramyasuda|R|', 'Irish|Ashley|A|']
D000328:Adult D001437:Bacteriuria D015331:Cohort Studies D006801:Humans D016030:Kidney Transplantation D008297:Male D008875:Middle Aged D044468:Native Hawaiian or Other Pacific Islander D011183:Postoperative Complications D012189:Retrospective Studies D066027:Transplant Recipients D014904:Western Australia
indigenous renal transplantation Aboriginal Aboriginal and Torres Strait Islander kidney transplantation transplant infectious disease