Clinical Study On Prevention And Treatment Of Infectious Diseases After Organ Donation And Kidney Transplantation After Citizens' Death

Objective: This study aimed to analyze the infection characteristics and related risk factors of infectious diseases in patients after organ donation and kidney transplantation after the death of our citizens,to explore prevention and treatment measures for infectious diseases,and to improve the survival rate of DCD transplanted kidneys.Methods: A retrospective analysis of the clinical data of 68 patients who underwent DCD renal transplantation from January 2007 to December 2018 in our hospital.A total of 46 patients with complete data were selected,and 21 patients with infection were summarized.The characteristics of infection,the incidence,location and pathogen distribution of various infectious diseases were counted,and the influencing factors and their laws related to infection were analyzed.RESULTS: 1)In 21 of the 46 cases,there were infections with a total infection rate of45.65%.There were 12 cases of urinary tract infection,accounting for 57.14%,6 cases of pulmonary infection,accounting for 28.57%,1 case of intracranial infection,accounting for 4.67%,and 2 cases of mixed infection,accounting for 9.52%.The identified pathogens were 19 cases,including 18 cases of bacterial infection,accounting for 94.73%(including 14 cases of Gram-negative bacteria,accounting for 73.68%,4 cases of Gram-positive bacteria,accounting for 21.05%),and 1 case of fungal infection,accounting for 5.2.%.2)Cold ischemia time(?10h),warm ischemia time(?20min),vasoactive drug use,ICU stay time,etc.are single factors of donor-induced infectious diseases after DCD kidney transplantation.3)Dialysis time,urinary catheter indwelling time,DJ indwelling time,methylprednisolone dosage,ATG dosage,blood creatinine decrease in 1 week,thrombocytopenia,postoperative body temperature >38 ° C duration,acute rejection,smoking history History of diabetes is a single factor in the development of infectious diseases after DCM transplantation in the recipients;4)Multivariate logistic regression analysis of single factors with P<0.05 found that independent risk factors affecting infectious diseases after DCD renal transplantation For CIT(? 10h),donor,recipient ICU stay time(? 72h),smoking history,diabetes history,etc.;Conclusion:(1)The incidence of postoperative urinary tract infection is the highest in DCD kidney transplant recipients.The pathogen is mainly Gram-negative bacteria.Therefore,the pathogen examination should be sent early,and the drug should be rationally used according to the drug sensitivity results.Early prevention of urinary tract infections with antibiotics sensitive to Gram-negative bacteria.(2)Reducing the length of donor and recipient ICU hospitalization,early removal of indwelling catheters,early bed-out activities,and active control of primary disease are important for reducing the incidence of infection after DCD kidney transplantation.(3)CIT(?10h),ICU stay time(? 72h)and smoking history,diabetes history are independent risk factors for infectious diseases after DCD renal transplantation.