Abstract: TH-PO1022
Sepsis and In-Hospital Outcomes in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Outcomes, Malignancy, and Pathology
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Waqas, Aimal, Foundation University Islamabad, Islamabad, Islamabad Capital Territory, Pakistan
- Zafar, Muhammad Usman, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Hutson, Stefan Charles, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
Background
Sepsis remains a leading cause of morbidity and mortality among kidney transplant recipients despite recent advancements in surgical techniques and immunosuppressive therapy. Immunosuppression and atypical clinical presentations may delay diagnosis and contribute to worse outcomes, including higher intensive care utilization, graft dysfunction, and death. Sepsis may also adversely affect long-term allograft survival. We used the National Inpatient Sample (NIS) to evaluate the impact of sepsis on in-hospital mortality among patients with a history of kidney transplantation.
Methods
We conducted a retrospective study using data from the NIS for 2017 – 2018. Adult hospitalizations (≥ 18 years) with a history of renal transplant were identified using ICD-10. Cases of sepsis were identified within this population. Outcomes assessed included in-hospital mortality, length of stay and hospital cost utilization. Multivariate logistic and linear regression analysis was performed using STATA MP version 19. The model adjusted for multiple comorbid conditions, including acute kidney injury (AKI), dialysis dependence, shock, coronary artery disease, hypertension, diabetes, chronic heart failure, chronic liver disease, and obesity.
Results
A total of 125,314 hospitalizations among kidney transplant recipients were analyzed. The mean age was 58 years and 42.83% were females. Sepsis was strongly associated with increased in-hospital mortality,10.73% (vs 1.54% in those without sepsis)(OR 5.65, 95% CI 5.17–6.16, p <0.001). Other predictors of mortality included chronic liver disease (OR 3.12), acute kidney injury (OR 2.10), dialysis (OR 1.68), and congestive heart failure (OR 1.35) and increasing age (OR 1.03 per year). Mean LOS was 6.74 days, and sepsis increased LOS by 3.32 days (95% CI 3.03-3.60). Mean hospitalization cost was $93146.84. Higher LOS and costs were also associated with AKI, dialysis requirement, shock, and chronic liver disease. Teaching hospitals had a higher LOS by ~2 days and an increased cost requirement.
Conclusion
Sepsis in kidney transplant recipients is associated with significantly higher mortality, prolonged hospitalization, and increased healthcare costs. Early recognition and prompt management may improve outcomes and reduce the healthcare burden in this vulnerable population.