Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience

IntroductionCatheter-related bloodstream infections (CRBSI) incidence is well-studied in general hemodialysis patients. There is a lack of data on CRBSI rates specifically in solid organ transplant (SOT) recipients requiring hemodialysis. This study aims to investigate CRBSI incidence in this popula...

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Main Authors: Christopher El Mouhayyar, Ayman Al Jurdi, Kassem Safa
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Transplantation
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Online Access:https://www.frontiersin.org/articles/10.3389/frtra.2025.1586035/full
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author Christopher El Mouhayyar
Christopher El Mouhayyar
Ayman Al Jurdi
Ayman Al Jurdi
Ayman Al Jurdi
Kassem Safa
Kassem Safa
Kassem Safa
author_facet Christopher El Mouhayyar
Christopher El Mouhayyar
Ayman Al Jurdi
Ayman Al Jurdi
Ayman Al Jurdi
Kassem Safa
Kassem Safa
Kassem Safa
author_sort Christopher El Mouhayyar
collection DOAJ
description IntroductionCatheter-related bloodstream infections (CRBSI) incidence is well-studied in general hemodialysis patients. There is a lack of data on CRBSI rates specifically in solid organ transplant (SOT) recipients requiring hemodialysis. This study aims to investigate CRBSI incidence in this population at a single center.MethodsThis retrospective, single-center cohort study at Massachusetts General Hospital (MGH) investigated CRBSI incidence in non-kidney SOT (i.e., heart, lung, liver) who required hemodialysis via a tunneled dialysis catheter (TDC). Data was collected from January 2016 to October 2024, with patients followed for up to two years post-transplant or until death/end of study.Results42 individuals met the study's inclusion criteria. The mean age of this cohort was 57 years, 50% were male, and 81% were White. The group consisted of 17 liver transplant recipients (40.5%), 13 heart transplant recipients (31.0%), and 12 lung transplant recipients (28.6%). Among the 12 lung transplant recipients, 8 received basiliximab induction, and 4 received no antibody induction therapy. 97% of the patients received mycophenolate mofetil, tacrolimus, and prednisone, while 3% received steroid-free maintenance. The median follow-up was 51.5 days (interquartile range 16–233). During this period, six individuals developed CRBSI, resulting in an incidence rate of 0.86 infections per 1,000 catheter-days. No deaths were attributed to CRBSI.ConclusionsOur findings suggest that intense immunosuppression in the setting of SOT is not associated with an increased risk of CRBSI in patients with renal failure utilizing TDC especially when a consistent and standardized protocol for the access and care of these catheters is utilized.
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spelling doaj-art-34b26f9424bc4885ae30b24890e712e22025-08-20T02:58:36ZengFrontiers Media S.A.Frontiers in Transplantation2813-24402025-05-01410.3389/frtra.2025.15860351586035Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experienceChristopher El Mouhayyar0Christopher El Mouhayyar1Ayman Al Jurdi2Ayman Al Jurdi3Ayman Al Jurdi4Kassem Safa5Kassem Safa6Kassem Safa7Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDivision of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesCenter for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, United StatesDivision of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesCenter for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, United StatesIntroductionCatheter-related bloodstream infections (CRBSI) incidence is well-studied in general hemodialysis patients. There is a lack of data on CRBSI rates specifically in solid organ transplant (SOT) recipients requiring hemodialysis. This study aims to investigate CRBSI incidence in this population at a single center.MethodsThis retrospective, single-center cohort study at Massachusetts General Hospital (MGH) investigated CRBSI incidence in non-kidney SOT (i.e., heart, lung, liver) who required hemodialysis via a tunneled dialysis catheter (TDC). Data was collected from January 2016 to October 2024, with patients followed for up to two years post-transplant or until death/end of study.Results42 individuals met the study's inclusion criteria. The mean age of this cohort was 57 years, 50% were male, and 81% were White. The group consisted of 17 liver transplant recipients (40.5%), 13 heart transplant recipients (31.0%), and 12 lung transplant recipients (28.6%). Among the 12 lung transplant recipients, 8 received basiliximab induction, and 4 received no antibody induction therapy. 97% of the patients received mycophenolate mofetil, tacrolimus, and prednisone, while 3% received steroid-free maintenance. The median follow-up was 51.5 days (interquartile range 16–233). During this period, six individuals developed CRBSI, resulting in an incidence rate of 0.86 infections per 1,000 catheter-days. No deaths were attributed to CRBSI.ConclusionsOur findings suggest that intense immunosuppression in the setting of SOT is not associated with an increased risk of CRBSI in patients with renal failure utilizing TDC especially when a consistent and standardized protocol for the access and care of these catheters is utilized.https://www.frontiersin.org/articles/10.3389/frtra.2025.1586035/fullAKIhemodialysisorgan transplantCRBSITDC
spellingShingle Christopher El Mouhayyar
Christopher El Mouhayyar
Ayman Al Jurdi
Ayman Al Jurdi
Ayman Al Jurdi
Kassem Safa
Kassem Safa
Kassem Safa
Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
Frontiers in Transplantation
AKI
hemodialysis
organ transplant
CRBSI
TDC
title Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
title_full Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
title_fullStr Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
title_full_unstemmed Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
title_short Incidence of catheter-related bloodstream infection (CRBSI) in immunosuppressed hosts post solid organ transplant (SOT): a single center experience
title_sort incidence of catheter related bloodstream infection crbsi in immunosuppressed hosts post solid organ transplant sot a single center experience
topic AKI
hemodialysis
organ transplant
CRBSI
TDC
url https://www.frontiersin.org/articles/10.3389/frtra.2025.1586035/full
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