Causes of death in renal transplant recipients. A review of autopsy findings from 1966 through 1985.

Published

Journal Article

From 1966 through 1985, a total of 640 patients received 739 renal transplants at a single center transplantation program. Of 245 total deaths, a slide and chart review of all 116 autopsied cases (47%) identified the major causes of death as pneumonia (n = 43), sepsis (n = 32), hemorrhage (n = 15), peritonitis (n = 11), meningitis (n = 7), and pulmonary embolism (n = 5). Eighty-five (73.3%) of these patients died of complications directly associated with immunosuppression, almost all (n = 82) as a result of infection. Organisms most frequently identified at death were gram-negative bacilli (n = 72), Candida species (n = 23), cytomegalovirus (n = 17), enterococcus (n = 14), Staphylococcus aureus (n = 11), Aspergillus species (n = 10), Pneumocystis carinii (n = 5), and mycobacteria (n = 5). Significant associations were found between bolus steroid antirejection therapy and infection with Aspergillus cytomegalovirus. Diabetics had a higher incidence of fungal infections and bowel perforation than nondiabetics. During this 20-year period, overall one-year actual patient survival rates for the four respective five-year intervals increased dramatically (69.9%, 68.2%, 83.3%, and 91.8%), but the normalized death rate showed a smaller decrease for infectious vs noninfectious causes.

Full Text

Duke Authors

Cited Authors

  • Scroggs, MW; Wolfe, JA; Bollinger, RR; Sanfilippo, F

Published Date

  • October 1, 1987

Published In

Volume / Issue

  • 111 / 10

Start / End Page

  • 983 - 987

PubMed ID

  • 3307685

Pubmed Central ID

  • 3307685

International Standard Serial Number (ISSN)

  • 0003-9985

Language

  • eng

Conference Location

  • United States