TABLE 1.
Baseline characteristics of the solid organ transplant recipients and deceased organ donors stratified by donor MDRO status
| Baseline characteristica,b | Recipients with negative donor cultures (N 88) |
Recipients with non-MDRO positive donor cultures (N 477) |
Recipients with an MDRO on donor culture (N 93) |
p valuec |
|---|---|---|---|---|
| Recipient baseline characteristics | ||||
| Demographics | ||||
| Age (median, IQR), years | 62 (53–66) | 59 (47–65) | 56 (50–64) | .09 |
| Female gender | 30 (34%) | 168 (35%) | 33 (35%) | .98 |
| Black race | 27 (31%) | 158 (33%) | 27 (29%) | .70 |
| White race | 51 (58%) | 277 (58%) | 60 (65%) | .50 |
| Asian race | 5 (6%) | 13 (3%) | 3 (3%) | .35 |
| Hispanic ethnicity | 4 (5%) | 35 (7%) | 9 (10%) | .41 |
| Organ transplant type | ||||
| Kidney | 37 (42%) | 192 (40%) | 46 (49%) | .26 |
| Liver | 26 (30%) | 134 (28%) | 22 (24%) | .62 |
| Lung | 18 (20%) | 96 (20%) | 17 (18%) | .91 |
| Heart | 9 (10%) | 80 (17%) | 16 (17%) | .29 |
| Pancreas | 1 (1%) | 3 (1%) | 1 (1%) | .42 |
| Comorbidities | ||||
| Diabetes mellitus | 31 (35%) | 143 (30%) | 40 (43%) | .04 |
| Hypertension | 55 (63%) | 288 (60%) | 60 (65%) | .73 |
| Chronic kidney diseased | 49 (56%) | 240 (50%) | 49 (53%) | .63 |
| Cirrhosise | 24 (27%) | 122 (26%) | 20 (22%) | .64 |
| Structural lung diseasef | 23 (26%) | 111 (23%) | 19 (20%) | .66 |
| Heart failure or cardiomyopathyg | 13 (15%) | 109 (23%) | 21 (23%) | .24 |
| Charlson comorbidity index (median, IQR) | 4 (3–6) | 4 (2–6) | 4 (2-6) | .38 |
| Pretransplant characteristics | ||||
| Days on waitlist (median, IQR) | 271 (65–890) | 206 (46–778) | 236 (57–638) | .91 |
| Intensive care unit pretransplantationh | 10 (11%) | 42 (9%) | 8 (9%) | .73 |
| Mechanical ventilation pretransplantationh | 3 (3%) | 14 (3%) | 1 (1%) | .59 |
| Renal replacement therapy pretransplantationh | 39 (45%) | 183 (39%) | 40 (44%) | .39 |
| Pretransplantation infectionsi | ||||
| Lower respiratory tract infection | 9 (10%) | 42 (9%) | 8 (9%) | .90 |
| Skin or soft tissue infection | 2 (2%) | 6 (1%) | 4 (4%) | .08 |
| Urinary tract infection | 6 (7%) | 20 (4%) | 1 (1%) | .13 |
| Bloodstream infection | 1 (1%) | 12 (3%) | 0 (0%) | .31 |
| Intra-abdominal infection | 3 (3%) | 14 (3%) | 4 (4%) | .72 |
| Laboratory valuesj | ||||
| Albumin (median, IQR), g/dl | 3.6 (3.0–4.1) | 3.6 (2.8–4.1) | 3.6 (3.0–4.2) | .06 |
| CMV seropositive | 49 (56%) | 268 (56%) | 58 (62%) | .53 |
| EBV seropositive | 86 (98%) | 448 (94%) | 87 (94%) | .34 |
| HCV seropositive | 6 (10%) | 53 (16%) | 12 (16%) | .53 |
| Donor baseline characteristics | ||||
| Age (median, IQR), years | 43 (26-51) | 36 (27–50) | 32 (25–47) | .05 |
| Female gender | 46 (52%) | 174 (36%) | 39 (42%) | .02 |
| Comorbidities | ||||
| Diabetes mellitus | 4 (5%) | 51 (11%) | 9 (10%) | .20 |
| Hypertension | 29 (33%) | 105 (22%) | 26 (28%) | .06 |
| Donor substance use | ||||
| Tetrahydrocannabinol/marijuana usek | 10 (11%) | 63 (13%) | 20 (22%) | .08 |
| Injection drug use | 10 (11%) | 108 (23%) | 25 (27%) | .03 |
| Death mechanism | ||||
| Drug overdose | 8 (9%) | 121 (25%) | 24 (26%) | <.01 |
| Asphyxiation | 8 (9%) | 20 (4%) | 10 (11%) | .02 |
| Cardiovascular | 14 (16%) | 116 (24%) | 20 (22%) | .21 |
| Gunshot wound | 10 (11%) | 37 (8%) | 6 (6%) | .43 |
| Blunt injury | 18 (20%) | 64 (13%) | 12 (13%) | .21 |
| Intracranial hemorrhage | 27 (31%) | 112 (23%) | 19 (20%) | .24 |
| Donor type | ||||
| Donation after circulatory death | 12 (14%) | 41 (9%) | 16 (17%) | .03 |
| Expanded criteria donor | 20 (23%) | 68 (14%) | 15 (16%) | .13 |
| PHS-increased risk | 19 (22%) | 184 (39%) | 31 (33%) | .01 |
| Donor laboratory values | ||||
| CMV seropositive | 49 (56%) | 249 (52%) | 47 (51%) | .77 |
| EBV seropositive | 78 (89%) | 439 (92%) | 87 (94%) | .43 |
| HCV seropositive | 3 (3%) | 20 (4%) | 5 (5%) | .80 |
| Donor management | ||||
| Length of stay during terminal hospitalization (median, IQR), days | 3 (2–4) | 4 (2–5) | 4 (2-7) | <.01 |
| Corticosteroid administrationl | 51 (58%) | 296 (62%) | 55 (59%) | .71 |
| Antimicrobial administration during terminal hospitalization | 84 (95%) | 471 (99%) | 88 (97%) | .08 |
Abbreviations: CMV, cytomegalovirus; EBV, Epstein–Barr virus; HCV, hepatitis C virus; IQR, interquartile range; MDRO, multidrug-resistant organism; PHS, Public Health Service.
Data are presented as numbers (percentages) except where noted.
Only those variables with a p value < .20, those of notable biologic importance, and those included in the final multivariable models are shown in this table.
The provided p value reflects a comparison of the three exposure groups.
Two-hundred thirty-nine (71%) of those with chronic kidney diseases were kidney transplant recipients.
One-hundred fifty-nine (96%) of those with cirrhosis were liver transplant recipients.
One-hundred nineteen (78%) of those with structural lung disease were lung transplant recipients.
One hundred (70%) of those with heart failure/cardiomyopathy were heart transplant recipients.
Assessed in the 24 h prior to transplantation.
Assessed in the 7 days prior to transplantation. In order to be categorized as having the infection pretransplantation, the transplant recipient had to be on ongoing antimicrobial therapy for the designated infection within 7 days of transplantation.
The most recent value prior to transplantation is included.
Defined by tetrahydrocannabinol detection on toxicology screen taken on admission to the donor’s terminal hospitalization.
Administered as part of “T4 protocol” by the organ procurement organization, in which high-dose corticosteroids, thyroxine (T4), insulin, and vasopressin are administered.