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조회308

성균관대학교

J. Heart Lung Transplant., Available online 6 August 2022 | https://doi.org/10.1016/j.healun.2022.08.001 Clinical impact and economic burden of post-transplant infections following heart transplantation: A retrospective nationwide cohort study

Suk-Chan Jang PharmD^a, Byeong-Chan Oh PharmD^a, Jin Hyun Nam PhD^b, Eui-Kyung LeePhD^a, Hye-Lin Kim PhD^c,1, Sun-Hong Kwon PhD^a,1

^aSchool of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Republic of Korea
^bDivision of Big Data Science, Korea University Sejong Campus, Sejong, Republic of Korea
^cCollege of Pharmacy, Sahmyook University, Seoul, Republic of Korea

¹These authors have contributed equally to this work.
Corresponding author: Hye-Lin Kim, Sun-Hong Kwon

Abstract

Background
Post-transplant infections are associated with high mortality rates. This retrospective nationwide cohort study examined the incidence and risk factors of infections requiring hospitalization after heart transplantation and the associated economic burden.

Methods
The entire heart transplant recipients' data from the Korean Health Insurance Review and Assessment Service between 2013 and 2020 was used. We estimated the annual incidence of post-transplant infections and adjusted incidence rate ratios (aIRR) of risk factors for reported infections using the poisson generalized linear model.

Results
Among 1,030 heart transplant recipients (324 with and 706 without post-transplant infections), 0.45 post-transplant infections were reported annually, with respiratory tract infections constituting the highest proportion (0.16). The risk of post-transplant infections was high in recipients with renal failure (aIRR = 1.35; 95% confidence interval [CI], 1.05–1.75) or nosocomial infection (aIRR = 1.47; 95% CI, 1.15–1.87). Combination regimens, including mammalian target of rapamycin inhibitor (mTORi), did not differ significantly from the standard 3 drug regimen (aIRR = 1.16; 95% CI, 0.80–1.67). The risk of death was higher among recipients with post-transplant infections than in uninfected recipients (adjusted hazard ratio = 4.59; 95% CI, 2.19–9.65). The mean follow-up cost per patient per month was 2-fold higher in recipients with post-transplant infections than in uninfected recipients ($5,096 and $2,532, respectively; p < .001).

Conclusions
mTORi combination, which reportedly maintains renal function, can be considered, as it does not increase the infection risk. Post-transplant infections present clinical and economic burdens, warranting careful observation of at-risk patients.

논문정보

형식Research article
게재일2022년 08월 (BRIC 등록일 2022-10-27)
연구진국내 연구진
분야 의약학 > 약학

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