PDF herunterladen
Semin Respir Crit Care Med 2021; 42(05): 717-725
DOI: 10.1055/s-0041-1735150
Review Article

Survival Outcome of Sepsis in Recipients of Solid Organ Transplant

Diana F. Florescu
1   Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, Nebraska
2   Transplant Surgery Program, University of Nebraska Medical Center, Omaha, Nebraska
,
Andre C. Kalil
1   Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, Nebraska
› Institutsangaben
› Weitere Informationen
    Lizenzen und Reprints

Abstract

Sepsis is a complex disease stemming from a dysregulated immune response toward an infectious agent. In transplantation, sepsis remains one of the leading causes of morbidity and mortality. Solid organ transplant recipients have impaired adaptive immunity due to immunosuppression required to prevent rejection. Immunosuppression has unintended consequences, such as increasing the risk of infections and sepsis. Due to its high morbidity and mortality, early detection of sepsis is paramount to start aggressive treatment. Several biomarkers or combination of biomarkers of sepsis have emerged in the last decade, but they are not dependable for early diagnosis or for outcome prognosis.

Keywords

sepsis - survival - outcome - solid organ transplant


Publikationsverlauf

Artikel online veröffentlicht:
20. September 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Hamandi B, Law N, Alghamdi A, Husain S, Papadimitropoulos EA. Clinical and economic burden of infections in hospitalized solid organ transplant recipients compared with the general population in Canada - a retrospective cohort study. Transpl Int 2019; 32 (10) 1095-1105
    CrossrefPubMedGoogle Scholar
  • 2 Kalil AC, Opal SM. Sepsis in the severely immunocompromised patient. Curr Infect Dis Rep 2015; 17 (06) 487
    CrossrefPubMedGoogle Scholar
  • 3 Gotur DB, Masud FN, Ezeana CF. et al. Sepsis outcomes in solid organ transplant recipients. Transpl Infect Dis 2020; 22 (01) e13214
    CrossrefPubMedGoogle Scholar
  • 4 Rhodes A, Evans LE, Alhazzani W. et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 2017; 43 (03) 304-377
    CrossrefPubMedGoogle Scholar
  • 5 Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update. Intensive Care Med 2018; 44 (06) 925-928
    CrossrefPubMedGoogle Scholar
  • 6 Wang Y, Gu Y, Huang F. et al. Risk factors for sepsis based on sepsis-3 criteria after orthotopic liver transplantation. Mediators Inflamm 2018; 2018: 8703172
    CrossrefPubMedGoogle Scholar
  • 7 Guenette A, Husain S. Infectious complications following solid organ transplantation. Crit Care Clin 2019; 35 (01) 151-168
    CrossrefPubMedGoogle Scholar
  • 8 Trzeciak S, Sharer R, Piper D. et al. Infections and severe sepsis in solid-organ transplant patients admitted from a university-based ED. Am J Emerg Med 2004; 22 (07) 530-533
    CrossrefPubMedGoogle Scholar
  • 9 Kalil AC, Syed A, Rupp ME. et al. Is bacteremic sepsis associated with higher mortality in transplant recipients than in nontransplant patients? A matched case-control propensity-adjusted study. Clin Infect Dis 2015; 60 (02) 216-222
    CrossrefPubMedGoogle Scholar
  • 10 Donnelly JP, Locke JE, MacLennan PA. et al. Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis. Clin Infect Dis 2016; 63 (02) 186-194
    CrossrefPubMedGoogle Scholar
  • 11 de Carvalho MA, Freitas FG, Silva Junior HT, Bafi AT, Machado FR, Pestana JO. Mortality predictors in renal transplant recipients with severe sepsis and septic shock. PLoS One 2014; 9 (11) e111610
    CrossrefPubMedGoogle Scholar
  • 12 Sawyer RG, Crabtree TD, Gleason TG, Antevil JL, Pruett TL. Impact of solid organ transplantation and immunosuppression on fever, leukocytosis, and physiologic response during bacterial and fungal infections. Clin Transplant 1999; 13 (03) 260-265
    CrossrefPubMedGoogle Scholar
  • 13 Pelletier SJ, Crabtree TD, Gleason TG. et al. Characteristics of infectious complications associated with mortality after solid organ transplantation. Clin Transplant 2000; 14 (4, pt 2): 401-408
    CrossrefPubMedGoogle Scholar
  • 14 Bafi AT, Tomotani DY, de Freitas FG. Sepsis in solid-organ transplant patients. Shock 2017; b (1S): (Suppl. 01) 12-16
    CrossrefPubMedGoogle Scholar
  • 15 Bige N, Zafrani L, Lambert J. et al. Severe infections requiring intensive care unit admission in kidney transplant recipients: impact on graft outcome. Transpl Infect Dis 2014; 16 (04) 588-596
    CrossrefPubMedGoogle Scholar
  • 16 Chou NK, Ko WJ, Chi NH. et al. Sparing immunosuppression in heart transplant recipients with severe sepsis. Transplant Proc 2006; 38 (07) 2145-2146
    CrossrefPubMedGoogle Scholar
  • 17 Sun Q, Liu ZH, Chen J. et al. An aggressive systematic strategy for acute respiratory distress syndrome caused by severe pneumonia after renal transplantation. Transpl Int 2006; 19 (02) 110-116
    CrossrefPubMedGoogle Scholar
  • 18 Bodro M, Sabé N, Tubau F. et al. Extensively drug-resistant Pseudomonas aeruginosa bacteremia in solid organ transplant recipients. Transplantation 2015; 99 (03) 616-622
    CrossrefPubMedGoogle Scholar
  • 19 Wan Q, Luo A, Ye Q, Liu S, Zhou J. Predictors of shock and mortality in solid organ transplant recipients with bacteremia caused by non-lactose-fermenting gram-negative bacilli. Infect Dis (Lond) 2016; 48 (01) 32-39
    CrossrefPubMedGoogle Scholar
  • 20 Kalil AC, Dakroub H, Freifeld AG. Sepsis and solid organ transplantation. Curr Drug Targets 2007; 8 (04) 533-541
    CrossrefPubMedGoogle Scholar
  • 21 McCreery RJ, Florescu DF, Kalil AC. Sepsis in immunocompromised patients without human immunodeficiency virus. J Infect Dis 2020; 222 (Suppl. 02) S156-S165
    CrossrefPubMedGoogle Scholar
  • 22 Kalil AC, Sandkovsky U, Florescu DF. Severe infections in critically ill solid organ transplant recipients. Clin Microbiol Infect 2018; 24 (12) 1257-1263
    CrossrefPubMedGoogle Scholar
  • 23 Wagener MM, Yu VL. Bacteremia in transplant recipients: a prospective study of demographics, etiologic agents, risk factors, and outcomes. Am J Infect Control 1992; 20 (05) 239-247
    CrossrefPubMedGoogle Scholar
  • 24 Weinstein MP, Towns ML, Quartey SM. et al. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis 1997; 24 (04) 584-602
    CrossrefPubMedGoogle Scholar
  • 25 Oriol I, Sabé N, Melilli E. et al. Factors influencing mortality in solid organ transplant recipients with bloodstream infection. Clin Microbiol Infect 2015; 21 (12) 1104.e9-1104.e14
    CrossrefPubMedGoogle Scholar
  • 26 Camargo LF, Marra AR, Pignatari AC. et al; Brazilian SCOPE Study Group. Nosocomial bloodstream infections in a nationwide study: comparison between solid organ transplant patients and the general population. Transpl Infect Dis 2015; 17 (02) 308-313
    CrossrefPubMedGoogle Scholar
  • 27 Montano-Loza AJ. Muscle wasting: a nutritional criterion to prioritize patients for liver transplantation. Curr Opin Clin Nutr Metab Care 2014; 17 (03) 219-225
    CrossrefPubMedGoogle Scholar
  • 28 Neviere R, Trinh-Duc P, Hulo S. et al. Predictive value of exhaled nitric oxide and aerobic capacity for sepsis complications after liver transplantation. Transpl Int 2016; 29 (12) 1307-1316
    CrossrefPubMedGoogle Scholar
  • 29 Toshima T, Shirabe K, Kurihara T. et al. Profile of plasma amino acids values as a predictor of sepsis in patients following living donor liver transplantation: Special reference to sarcopenia and postoperative early nutrition. Hepatol Res 2015; 45 (12) 1170-1177
    CrossrefPubMedGoogle Scholar
  • 30 Candel FJ, Grima E, Matesanz M. et al. Bacteremia and septic shock after solid-organ transplantation. Transplant Proc 2005; 37 (09) 4097-4099
    CrossrefPubMedGoogle Scholar
  • 31 Nemes B, Sárváry E, Sótonyi P. et al. Factors in association with sepsis after liver transplantation: the Hungarian experience. Transplant Proc 2005; 37 (05) 2227-2228
    CrossrefPubMedGoogle Scholar
  • 32 Yoshizumi T, Shirabe K, Ikegami T. et al. Decreased immunoglobulin G levels after living-donor liver transplantation is a risk factor for bacterial infection and sepsis. Transpl Infect Dis 2014; 16 (02) 225-231
    CrossrefPubMedGoogle Scholar
  • 33 Sugimoto T, Sakaguchi M, Ogawa N. et al. Marked hypercalcaemia in sepsis-induced multiple organ failure. Nephrol Dial Transplant 2007; 22 (04) 1272-1273
    CrossrefPubMedGoogle Scholar
  • 34 Kinnunen S, Karhapää P, Juutilainen A, Finne P, Helanterä I. Secular trends in infection-related mortality after kidney transplantation. Clin J Am Soc Nephrol 2018; 13 (05) 755-762
    CrossrefPubMedGoogle Scholar
  • 35 Nakamura M, Seki G, Iwadoh K. et al. Acute kidney injury as defined by the RIFLE criteria is a risk factor for kidney transplant graft failure. Clin Transplant 2012; 26 (04) 520-528
    CrossrefPubMedGoogle Scholar
  • 36 Moreno A, Cervera C, Gavaldá J. et al. Bloodstream infections among transplant recipients: results of a nationwide surveillance in Spain. Am J Transplant 2007; 7 (11) 2579-2586
    CrossrefPubMedGoogle Scholar
  • 37 Kao KC, Chiu LC, Hung CY. et al. Coinfection and mortality in pneumonia-related acute respiratory distress syndrome patients with bronchoalveolar lavage: a prospective observational study. Shock 2017; 47 (05) 615-620
    CrossrefPubMedGoogle Scholar
  • 38 Haak BW, Prescott HC, Wiersinga WJ. Therapeutic potential of the gut microbiota in the prevention and treatment of sepsis. Front Immunol 2018; 9: 2042
    CrossrefPubMedGoogle Scholar
  • 39 Lee J, Banerjee D. Metabolomics and the microbiome as biomarkers in sepsis. Crit Care Clin 2020; 36 (01) 105-113
    CrossrefPubMedGoogle Scholar
  • 40 Dickson RP. The microbiome and critical illness. Lancet Respir Med 2016; 4 (01) 59-72
    CrossrefPubMedGoogle Scholar
  • 41 Sharma NK, Salomao R. Sepsis through the eyes of proteomics: the progress in the last decade. Shock 2017; 47 (1S): (Suppl. 01) 17-25
    CrossrefPubMedGoogle Scholar
  • 42 Stringer KA, Serkova NJ, Karnovsky A, Guire K, Paine III R, Standiford TJ. Metabolic consequences of sepsis-induced acute lung injury revealed by plasma 1H-nuclear magnetic resonance quantitative metabolomics and computational analysis. Am J Physiol Lung Cell Mol Physiol 2011; 300 (01) L4-L11
    CrossrefPubMedGoogle Scholar
  • 43 Schmerler D, Neugebauer S, Ludewig K, Bremer-Streck S, Brunkhorst FM, Kiehntopf M. Targeted metabolomics for discrimination of systemic inflammatory disorders in critically ill patients. J Lipid Res 2012; 53 (07) 1369-1375
    CrossrefPubMedGoogle Scholar
  • 44 Ferrario M, Cambiaghi A, Brunelli L. et al. Mortality prediction in patients with severe septic shock: a pilot study using a target metabolomics approach. Sci Rep 2016; 6: 20391
    CrossrefPubMedGoogle Scholar
  • 45 Qian WJ, Jacobs JM, Camp II DG. et al. Comparative proteome analyses of human plasma following in vivo lipopolysaccharide administration using multidimensional separations coupled with tandem mass spectrometry. Proteomics 2005; 5 (02) 572-584
    CrossrefPubMedGoogle Scholar
  • 46 DeCoux A, Tian Y, DeLeon-Pennell KY. et al. Plasma glycoproteomics reveals sepsis outcomes linked to distinct proteins in common pathways. Crit Care Med 2015; 43 (10) 2049-2058
    CrossrefPubMedGoogle Scholar
  • 47 Malmström E, Davidova A, Mörgelin M. et al. Targeted mass spectrometry analysis of neutrophil-derived proteins released during sepsis progression. Thromb Haemost 2014; 112 (06) 1230-1243
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 48 Liu J, Li J, Deng X. Proteomic analysis of differential protein expression in platelets of septic patients. Mol Biol Rep 2014; 41 (05) 3179-3185
    CrossrefPubMedGoogle Scholar
  • 49 Shen Z, Want EJ, Chen W. et al. Sepsis plasma protein profiling with immunodepletion, three-dimensional liquid chromatography tandem mass spectrometry, and spectrum counting. J Proteome Res 2006; 5 (11) 3154-3160
    CrossrefPubMedGoogle Scholar
  • 50 Andaluz-Ojeda D, Bobillo F, Iglesias V. et al. A combined score of pro- and anti-inflammatory interleukins improves mortality prediction in severe sepsis. Cytokine 2012; 57 (03) 332-336
    CrossrefPubMedGoogle Scholar
  • 51 Punyadeera C, Schneider EM, Schaffer D. et al. A biomarker panel to discriminate between systemic inflammatory response syndrome and sepsis and sepsis severity. J Emerg Trauma Shock 2010; 3 (01) 26-35
    CrossrefPubMedGoogle Scholar
  • 52 Ludwig KR, Hummon AB. Mass spectrometry for the discovery of biomarkers of sepsis. Mol Biosyst 2017; 13 (04) 648-664
    CrossrefPubMedGoogle Scholar
  • 53 Sandkovsky U, Kalil AC, Florescu DF. The use and value of procalcitonin in solid organ transplantation. Clin Transplant 2015; 29 (08) 689-696
    CrossrefPubMedGoogle Scholar
  • 54 Memar MY, Baghi HB. Presepsin: a promising biomarker for the detection of bacterial infections. Biomed Pharmacother 2019; 111: 649-656
    CrossrefPubMedGoogle Scholar
  • 55 Wu J, Hu L, Zhang G, Wu F, He T. Accuracy of presepsin in sepsis diagnosis: a systematic review and meta-analysis. PLoS One 2015; 10 (07) e0133057
    CrossrefPubMedGoogle Scholar
  • 56 Tziolos N, Kotanidou A, Orfanos SE. Biomarkers in infection and sepsis: can they really indicate final outcome?. Int J Antimicrob Agents 2015; 46 (Suppl. 01) S29-S32
    CrossrefPubMedGoogle Scholar
  • 57 Dolin HH, Papadimos TJ, Stepkowski S, Chen X, Pan ZK. A novel combination of biomarkers to herald the onset of sepsis prior to the manifestation of symptoms. Shock 2018; 49 (04) 364-370
    CrossrefPubMedGoogle Scholar
  • 58 Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis 2013; 13 (05) 426-435
    CrossrefPubMedGoogle Scholar
  • 59 Yang Y, Xie J, Guo F. et al. Combination of C-reactive protein, procalcitonin and sepsis-related organ failure score for the diagnosis of sepsis in critical patients. Ann Intensive Care 2016; 6 (01) 51
    CrossrefPubMedGoogle Scholar
  • 60 Han JH, Nachamkin I, Coffin SE. et al; Prevention Epicenters Program of the Centers for Disease Control and Prevention. Use of a combination biomarker algorithm to identify medical intensive care unit patients with suspected sepsis at very low likelihood of bacterial infection. Antimicrob Agents Chemother 2015; 59 (10) 6494-6500
    CrossrefPubMedGoogle Scholar
  • 61 Shapiro NI, Trzeciak S, Hollander JE. et al. A prospective, multicenter derivation of a biomarker panel to assess risk of organ dysfunction, shock, and death in emergency department patients with suspected sepsis. Crit Care Med 2009; 37 (01) 96-104
    CrossrefPubMedGoogle Scholar
  • 62 Mearelli F, Fiotti N, Giansante C. et al. Derivation and validation of a biomarker-based clinical algorithm to rule out sepsis from noninfectious systemic inflammatory response syndrome at emergency department admission: a multicenter prospective study. Crit Care Med 2018; 46 (09) 1421-1429
    CrossrefPubMedGoogle Scholar
  • 63 Schinkel M, Paranjape K, Nannan Panday RS, Skyttberg N, Nanayakkara PWB. Clinical applications of artificial intelligence in sepsis: A narrative review. Comput Biol Med 2019; 115: 103488
    CrossrefPubMedGoogle Scholar
  • 64 Rhee C, Dantes R, Epstein L. et al; CDC Prevention Epicenter Program. Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014. JAMA 2017; 318 (13) 1241-1249
    CrossrefPubMedGoogle Scholar