Clinical features and risk factors of early postoperative infections in living kidney transplant recipients

HOU Wenjing; ZHU Yichen; LIN Jun; ZHANG Jian; HE Chaoran; GUO Heng

doi:10.3969/j.issn.1004-3594.2026.07.005

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Medical Journal of the Chinese People Armed Police Forces ›› 2026, Vol. 37 ›› Issue (7) : 575-580. DOI: 10.3969/j.issn.1004-3594.2026.07.005

ORIGINAL ARTICLES

Clinical features and risk factors of early postoperative infections in living kidney transplant recipients

HOU Wenjing¹, ZHU Yichen², LIN Jun², ZHANG Jian², HE Chaoran¹, GUO Heng¹

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Abstract

Objective To analyze the clinical features and risk factors of early postoperative infection in living kidney transplant recipients, and to provide basis for the prevention and control of perioperative infection. Methods A retrospective study was conducted on the baseline information and clinical data of the patients who underwent living kidney transplantation in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2019 to October 2024. Univariate analysis and exploratory multivariate logistic regression analysis were used to identify risk factors of early postoperative infection. Results A total of 119 living kidney transplant recipients were included, among whom 22 received preoperative treatment with plasma exchange, rituximab, and/or eculizumab. Early postoperative infection occurred in 24 cases(20.17%), with urinary tract infection being the most common type(18/24, 75.00%). The predominant pathogens identified were enterococcus and enterobacter. Univariate analysis showed that the operation time was an influencing factor for early postoperative infection (OR=1.010, 95% CI: 1.002-1.018,P<0.05). Exploratory multivariate logistic regression analysis revealed that the operation time (OR=1.013, 95% CI: 1.003-1.023,P<0.05), diabetes mellitus (OR=19.040, 95% CI: 1.640-221.010,P<0.05), and methylprednisolone dose during induction immunotherapy (OR=1.172, 95% CI: 1.023-1.342,P<0.05) were related to early postoperative infection. Conclusions There is an infection risk after living kidney transplantation. Longer operation time, pre-existing diabetes mellitus, and a higher methylprednisolone dose during induction immunotherapy are associated with an increased risk of early postoperative infection.

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living kidney donation / kidney transplantation / early infection / pathogen / risk factors

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HOU Wenjing, ZHU Yichen, LIN Jun, ZHANG Jian, HE Chaoran, GUO Heng. Clinical features and risk factors of early postoperative infections in living kidney transplant recipients[J]. Medical Journal of the Chinese People Armed Police Forces. 2026, 37(7): 575-580 https://doi.org/10.3969/j.issn.1004-3594.2026.07.005

References

[1] 曾宪鹏, 夏秋翔, 李汉英, 等. 亲属肾移植供受者预后及风险分析[J].实用器官移植电子杂志, 2021, 9(6):491-495.
[2] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会. 中国活体供肾移植临床指南(2016版)[J]. 器官移植, 2016, 7(6):417-426.
[3] 中华医学会器官移植学分会. ABO血型不相容亲属活体肾移植技术操作规范(2019版)[J]. 器官移植, 2019, 10(5):533-539.
[4] Avery R K, Motter J D, Jackson K R, et al. Quantifying infection risks in incompatible living donor kidney transplant recipients[J]. Am J Transplant, 2021, 21(4):1564-1575.
[5] Hirzel C, Projer L, Atkinson A, et al. Infection risk in the first year after ABO-incompatible kidney transplantation: a nationwide prospective cohort study[J]. Transplantation, 2022, 106(9):1875-1883.
[6] Koo T Y, Lee J H, Min S I, et al. Presence of a survival benefit of HLA-incompatible living donor kidney transplantation compared to waiting or HLA-compatible deceased donor kidney transplantation with a long waiting time[J]. Kidney Int, 2021, 100(1):206-214.
[7] 中国医师协会器官移植医师分会, 中华医学会器官移植学分会. 中国实体器官移植手术部位感染管理专家共识(2022版)[J]. 器官移植, 2023, 14(1):11-23.
[8] Fishman J A. Introduction: infection in solid organ transplant recipients[J]. Am J Transplant, 2009, 9(Suppl 4):S3-S6.
[9] 中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志 2001, 81(5):314-320.
[10] 赵明辉. 肾脏病临床概览[M]. 北京: 北京大学医学出版社, 2020:133-183.
[11] Nishimura S, Inoue S, Sekito T, et al. Risk factors for perioperative urinary tract infection after living donor kidney transplantation characterized by high prevalence of desensitization therapy: a single-center analysis[J]. J Clin Med, 2025, 14(17):6102.
[12] 杨波, 徐媛, 李海洋, 等. 肾移植受者术后感染病原体分布及感染危险因素研究进展[J]. 转化医学杂志, 2025, 14(3):176-180.
[13] 刘彦妤, 岳慧杰, 陈晨, 等. 肾移植受者围手术期感染危险因素及预防用抗菌药物合理性的分析[J]. 医学研究生学报, 2020, 33(11):1181-1186.
[14] 尚鑫, 张莉. 肾移植术后感染患者病原菌分布特点及危险因素分析[J]. 新乡医学院学报, 2024, 41(12):1140-1143.
[15] Anastasopoulos N A, Charif R, Loucaidou M, et al. Outcomes of living donor kidney transplantation from extended criteria donors to extended criteria recipients: A retrospective cohort study[J]. World J Transplant, 2025, 15(4):111031.
[16] Kim D G, Lee J, Kim M S, et al. Outcomes of ABO-incompatible kidney transplantation in older patients: a national cohort study[J]. Transpl Int, 2021, 34(2):290-301.
[17] Kute V B, Pathak V, Ray D S, et al. A multicenter retrospective cohort study on management protocols and clinical outcomes after abo-incompatible kidney transplantation in India[J]. Transplantation, 2024, 108(2):545-555.
[18] Amara D, Grieco A, Foley D, et al. Urinary tract infection after kidney transplantation: some centers are doing better than others[J]. Clin Transplant, 2025, 39(11):e70357.
[19] Lam J, Elali I, Mahgoub M, et al. Early removal of ureteral stents when attached to the foley catheter in living donor kidney transplant recipients reduces urinary tract infections[J]. Clin Transplant, 2025, 39(10):e70329.
[20] 《抗菌药物临床应用指导原则》修订工作组. 抗菌药物临床应用指导原则:2015年版[M]. 北京: 人民卫生出版社, 2015:3-4.
[21] Anesi J A, Blumberg E A, Abbo L M. Perioperative antibiotic prophylaxis to prevent surgical site infections in solid organ transplantation[J]. Transplantation. 2018, 102(1):21-34.
[22] Ozawa K, Takai M, Taniguchi T, et al. Diabetes mellitus as a predictive factor for urinary tract infection for patients treated with kidney transplantation[J]. Medicina (Kaunas), 2022, 58(10):1488.
[23] Krohmals S, Terwangne C, Devresse A, et al. Diabetes mellitus as a risk factor for complicated urinary tract infections in kidney transplant recipients[J]. J Clin Med, 2025, 14(2):618.
[24] 张伟, 黄洁. 钠-葡萄糖共转运蛋白2抑制剂治疗2型糖尿病心肾并发症的研究进展[J]. 武警医学, 2024, 35(1):75-79.
[25] Lai G S, Li J R, Wang S S, et al. Influence of surgical complications on outcomes in kidney transplantation patients[J]. In Vivo, 2023, 37(6):2796-2802.
[26] 中华医学会器官移植学分会, 中国医疗保健国际交流促进会肾脏移植学分会. 中国肾脏移植受者免疫抑制治疗指南(2023 版)[J]. 中华器官移植杂志, 2024, 45(10):645-663.
[27] 王培宇, 丁汉东, 钟金彪, 等. 肾移植术后尿路感染209例的临床特点及危险因素分析[J]. 器官移植, 2024, 15(4):614-621.
[28] Martinez M G, Moreno P I, Budar L F, et al. Low-dose thymoglobulin vs basiliximab induction therapy in low-risk living related kidney transplant recipients: a prospective randomized trial[J]. Transplant Proc, 2021, 53(3):1005-1009.
[29] 侯轶博, 昌盛, 陈松, 等. 不同免疫诱导治疗方案对活体亲属ABO血型不相容肾移植受者术后早期临床结局的影响[J]. 中华器官移植杂志, 2023, 44(10):620-627.