A simple score can identify kidney transplant recipients at high risk of severe infection over the following 2 years

Claire Dendle, Kevan R. Polkinghorne, William R. Mulley, Poh Yi Gan, John Kanellis, Rhonda L. Stuart, Karin Thursky, Stephen R. Holdsworth

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5 Citations (Scopus)


Background: The aim of this study was to determine whether a composite score of simple immune biomarkers and clinical characteristics could predict severe infections in kidney transplant recipients. Methods: We conducted a prospective study of 168 stable kidney transplant recipients who underwent measurement of lymphocyte subsets, immunoglobulins, and renal function at baseline and were followed up for 2 years for the development of any severe infections, defined as infection requiring hospitalization. A point score was developed to predict severe infection based on logistic regression analysis of factors in baseline testing. Results: Fifty-nine (35%) patients developed severe infection, 36 (21%) had two or more severe infections, and 3 (2%) died of infection. A group of 19 (11%) patients had the highest predicted infectious risk (>60%), as predicted by the score. Predictive variables were mycophenolate use, graft function, CD4+, and natural killer cell number. The level of immunosuppression score had an area under the receiver operating curve of 0.75 (95% CI: 0.67-0.83). Conclusion: Our level of immunosuppression score for predicting the development of severe infection over 2 years has sufficient prognostic accuracy for identification of high-risk patients. This data can inform research that examines strategies to reduce the risks of infection.

Original languageEnglish
Article numbere13076
Number of pages9
JournalTransplant Infectious Disease
Issue number3
Publication statusPublished - Jun 2019


  • infection risk
  • kidney transplant risk
  • lymphocytes
  • natural killer cells
  • score

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