Single-center analysis of infectious complications in older adults during the first year after kidney transplantation

  • Marion Hemmersbach-MillerEmail author
  • Barbara D. Alexander
  • Debra L. Sudan
  • Carl Pieper
  • Kenneth E. Schmader
Original Article


Infections are among the top three causes of death of older adults in the first year after kidney transplantation (KT). Our aim was to describe infectious complications among KT recipients aged ≥ 65 during the first 12 months post-transplant. Single-center retrospective cohort study. Ninety-one KTs had been performed in patients ≥ 65 years of age between 2011 and 2015. 92.3% of the patients developed at least one infection. Infectious episodes increased the risk of future infection by 10% (p = 0.0018) with each infection portending a greater risk. At a patient level, viral (71.4%) and bacterial (70.2%) infections predominated. Urinary tract infections were the most frequent complication (30.3%), followed by cytomegalovirus infections (22.7%). Infections were the main reason for readmission. 7.7% of the patients developed rejection; and overall 3.3% lost their graft. Mortality at 1 year was 9.9%. Older KT recipients have a high incidence of infectious complications the first year after KT. Infections were the number one reason for readmission, and an infection episode predicted future infections for the individual patient. Despite these complications, the majority of older KT recipients were alive with a functioning graft at 1 year.


Kidney transplantation Infection Aged Epidemiology 



Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health under award number 5T32AI100851 (MHM, BDA). Dr. Schmader was supported by the National Institute on Aging, Duke Pepper Older Americans Independence Center P30AG028716.

Compliance with ethical standards

Ethical approval

For this type of study formal consent is not required.


The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Infectious DiseasesDuke University Medical CenterDurhamUSA
  2. 2.Division of Abdominal Transplant SurgeryDuke University Medical CenterDurhamUSA
  3. 3.Department of Biostatistics and BioinformaticsDuke UniversityDurhamUSA
  4. 4.Division of GeriatricsDuke University Medical CenterDurhamUSA
  5. 5.GRECCDurham VADurhamUSA

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