TY - JOUR
T1 - Risk factors for impaired wound healing in sirolimus-treated renal transplant recipients
AU - Knight, Richard J.
AU - Villa, Martin
AU - Laskey, Robert
AU - Benavides, Carlos
AU - Schoenberg, Linda
AU - Welsh, Maria
AU - Kerman, Ronald H.
AU - Podder, Hemangshu
AU - Van Buren, Charles T.
AU - Katz, Stephen M.
AU - Kahan, Barry D.
PY - 2007/7
Y1 - 2007/7
N2 - Aim: As sirolimus has been implicated in impaired wound healing, the aim of this study was to evaluate risk factors for wound complications after renal transplantation in patients treated with this drug de novo. Methods: This single center retrospective review of wound complications included 194 renal transplant recipients, all of whom received sirolimus immunosuppression in combination with reduced doses of cyclosporine (CsA) and corticosteroids de novo. A wound complication was defined as an infection, incisional hernia, or lymphocele. Results: The overall incidence of wound complications within the first year post-transplantation was 36% (n = 70) including infection in 12% (n = 23), lymphocele formation in 18% (n = 34), and incisional hernia in 18% (n = 34) of patients. Seventeen patients suffered more than one wound complication. A multivariate analysis showed that independent risk factors for the development of wound complications were recipients over the age of 40 yr (odds ratio 2.536, p = 0.011), subjects with body mass index (BMI) >26 (odds ratio 2.498, p = 0.027) and especially BMI >30 (odds ratio 3.738, p = 0.007), the use of thymoglobulin for induction immunosuppression (odds ratio 3.627, p = 0.002), and a cumulative dose of sirolimus of at least 35 mg by post-transplant day 4 (odds ratio 2.694, p = 0.023). African-American (odds ratio 0.139, p < 0.001) or Hispanic recipients (odds ratio 0.337, p = 0.014) were less likely to experience a wound problem than Caucasian recipients. Conclusion: A number of potentially modifiable risk factors independently increase the incidence of wound complications among renal transplant recipients receiving sirolimus-based immunosuppression de novo.
AB - Aim: As sirolimus has been implicated in impaired wound healing, the aim of this study was to evaluate risk factors for wound complications after renal transplantation in patients treated with this drug de novo. Methods: This single center retrospective review of wound complications included 194 renal transplant recipients, all of whom received sirolimus immunosuppression in combination with reduced doses of cyclosporine (CsA) and corticosteroids de novo. A wound complication was defined as an infection, incisional hernia, or lymphocele. Results: The overall incidence of wound complications within the first year post-transplantation was 36% (n = 70) including infection in 12% (n = 23), lymphocele formation in 18% (n = 34), and incisional hernia in 18% (n = 34) of patients. Seventeen patients suffered more than one wound complication. A multivariate analysis showed that independent risk factors for the development of wound complications were recipients over the age of 40 yr (odds ratio 2.536, p = 0.011), subjects with body mass index (BMI) >26 (odds ratio 2.498, p = 0.027) and especially BMI >30 (odds ratio 3.738, p = 0.007), the use of thymoglobulin for induction immunosuppression (odds ratio 3.627, p = 0.002), and a cumulative dose of sirolimus of at least 35 mg by post-transplant day 4 (odds ratio 2.694, p = 0.023). African-American (odds ratio 0.139, p < 0.001) or Hispanic recipients (odds ratio 0.337, p = 0.014) were less likely to experience a wound problem than Caucasian recipients. Conclusion: A number of potentially modifiable risk factors independently increase the incidence of wound complications among renal transplant recipients receiving sirolimus-based immunosuppression de novo.
KW - Renal transplant
KW - Sirolimus
KW - Wound healing
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U2 - 10.1111/j.1399-0012.2007.00668.x
DO - 10.1111/j.1399-0012.2007.00668.x
M3 - Article
C2 - 17645704
AN - SCOPUS:34547450198
SN - 0902-0063
VL - 21
SP - 460
EP - 465
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 4
ER -