Analysis of unknown-origin fever after simultaneous pancreas-kidney transplantation
10.3760/cma.j.cn421203-20211102-00267
- VernacularTitle:胰肾联合移植术后不明原因发热的临床分析
- Author:
Jianyong PAN
1
;
Yingxin FU
;
Yu CAO
;
Gang FENG
;
Jie ZHAO
;
Hui WANG
;
Xiaofeng SHI
;
Zhen WANG
;
Wenli SONG
;
Chunbai MO
Author Information
1. 天津市第一中心医院肾移植科，天津 300192
- Keywords:
Simultaneous-pancreas kidney transplantation;
Diabetes mellitus;
Fever of unknown origin;
Rejection
- From:
Chinese Journal of Organ Transplantation
2022;43(2):82-87
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features, etiologies and outcomes of unknown origin fever after simultaneous pancreas-kidney transplantation(SPK).Methods:From March 2015 to January 2020, clinical data were retrospectively reviewed for 120 SPK recipients.According to the definite evidence of fever, such as microbial culture, imaging findings or rejection, they were divided into three groups of free-fever(FF, n=41)and defined-fever(DF, n=47)and fever of unknown origin(FUO, n=32). The differences in general clinical features, surgical complications, laboratory tests and prognoses were compared.Logistic regression was employed for analyzing the risk factors of FUO and Kapla-Meier for survival analysis.And P<0.05 was deemed as statistically significant. Results:Multivariate analysis revealed that preoperative diabetic gastroenteropathy was an independent risk factor for unexplained fever.Significant differences existed between FUO and DF groups in leucocyte count[6.50(5.13, 7.36)vs.10.36(6.11, 12.97)×10 9/L], C-reactive protein(CRP)[11.75(6.25, 16.85)vs.35.00(16.30, 75.00)μg/ml], procalcitonin[0.13(0.06, 0.18)vs.0.19(0.11, 1.05)ng/ml]( P<0.001, P<0.001, P=0.025). As compared with DF group, 19 recipients in FUO group only received 1-2 antibiotics and there was a shorter course of treatment[13(40.6%)vs.32(68.1%), P=0.016]. For 6(18.7%)recipients after a diagnosis of FUO, clinical outcome was achieved with only NSAIDs.Length of stay was(48.72±19.51)days in FUO group versus(57.36±27.46)days in DF group and the difference was statistically significant( P<0.001). Hospitalization expenses of two groups were 253 463.25 and 334 605.96 yuan respectively and the difference was also statistically significant( P=0.002). Conclusions:Diabetic gastroenteropathy is an independent risk factor for early FUO after SPK transplantation.Inflammatory markers of leukocytes, CRP and procalcitonin in FUO patients are significantly lower than DF group.And these clinical features can help diagnose FUO in an early stage.
