Course and outcome of renal transplant recipients admitted to the intensive care unit: a 20-year study

Abstract

Background: Renal transplantation represents the main treatment for end-stage renal disease. The goal of this study was to evaluate the course and outcome of renal transplant recipients admitted to the intensive care unit (ICU) and to analyze factors determining prognosis and mortality.

Methods: The demographic features, data admission characteristics, and ICU courses of all renal transplant recipients admitted to our ICU from 1992 to 2012 were evaluated to analyze factors for mortality.

Results: Eleven women and 50 men of mean age 45.5 ± 12.5 years were included in the study. Acute Physiology And Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores on ICU admission were 20 ± 5.7 and 8.5 ± 3.5, respectively. The main reasons for admission were as follows: sepsis (n = 27) or immediate postoperative complications (n = 16). Thirty-five patients during their ICU stay required hemodialysis and 34 needed catecholamines. The mortality rate was 42.6%. APACHE II Score, dialysis requirement, and sepsis as a reason for ICU admission were independently related to the mortality.

Conclusions: The mortality rate was higher than that of the general ICU population (42.6% vs 30%). The main reason for ICU admission of renal transplant recipients was sepsis.