Abstract 2333: Outcome of Renal Transplant and Waitlisted Patients in the US with Endocarditis
Few data exist on the long-term survival of renal transplant (RT) pts with bacterial endocarditis (BE). We searched the records of 1,698,706 pts in the United States Renal Data System database and identified 47,899 RT pts and 62,520 pts waitlisted (WL) for RT in 1995–2003. We estimated incident rates of endocarditis for RT and WL pts. Long-term survival was estimated by Kaplan-Meier method and independent predictors of death were examined in a comorbidity-adjusted Cox model.
RESULTS: 288 RT pts and 556 WL pts were hospitalized for endocarditis. In-hospital death was 15.8% for RT and 18.4% for WL. Incident BE rates/1000 pt yrs were 5.6 for WL, 2.70 for deceased donor RT, and 1.90 for living donor RT. Adjusted hazard ratio for developing BE is 0.48(0.39,0.59) in deceased donor RT and 0.41 (0.30,0.58) in living donor RT vs. WL. The Table⇓ shows survival and predictors of death (Deceased donor, Age 45– 64, female, white, glomerulonephritis as primary ESRD cause, prior dialysis <1yr is reference) with risk ratio (RR).
Conclusion: Renal transplant pts with endocarditis sustain high mortality. Pts waitlisted for RT are at higher risk for developing endocarditis and dying from bacterial endocarditis than renal transplant pts.