2022
Waller, Karen M J; Mata, Nicole L De La; Wyburn, Kate R; Hedley, James A; Rosales, Brenda M; Kelly, Patrick J; Ramachandran, Vidiya; Shah, Karan K; Morton, Rachael L; Rawlinson, William D; Webster, Angela C
Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015 Journal Article
In: vol. 9, no. 8, 2022, ISSN: 2328-8957.
Abstract | Links | BibTeX | Tags: Infectious Diseases, Oncology, SAFEBOD
@article{Waller2022,
title = {Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015},
author = {Karen M J Waller and Nicole L De La Mata and Kate R Wyburn and James A Hedley and Brenda M Rosales and Patrick J Kelly and Vidiya Ramachandran and Karan K Shah and Rachael L Morton and William D Rawlinson and Angela C Webster},
doi = {10.1093/ofid/ofac337},
issn = {2328-8957},
year = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
volume = {9},
number = {8},
publisher = {Oxford University Press (OUP)},
abstract = {<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Infections, including common communicable infections such as influenza, frequently cause disease after organ transplantation, although the quantitative extent of infection and disease remains uncertain.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A cohort study was conducted to define the burden of notifiable infectious diseases among all solid organ recipients transplanted in New South Wales, Australia, 2000–2015. Data linkage was used to connect transplant registers to hospital admissions, notifiable diseases, and the death register. Standardized incidence ratios (SIRs) were calculated relative to general population notification rates, accounting for age, sex, and calendar year. Infection-related hospitalizations and deaths were identified.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Among 4858 solid organ recipients followed for 39 183 person-years (PY), there were 792 notifications. Influenza was the most common infection (532 cases; incidence, 1358 [95% CI, 1247–1478] per 100 000 PY), highest within 3 months posttransplant. Next most common was salmonellosis (46 cases; incidence, 117 [95% CI, 87–156] per 100 000 PY), then pertussis (38 cases; incidence, 97 [95% CI, 71–133] per 100 000 PY). Influenza and invasive pneumococcal disease (IPD) showed significant excess cases compared with the general population (influenza SIR, 8.5 [95% CI, 7.8–9.2]; IPD SIR, 9.8 [95% CI, 6.9–13.9]), with high hospitalization rates (47% influenza cases, 68% IPD cases) and some mortality (4 influenza and 1 IPD deaths). By 10 years posttransplant, cumulative incidence of any vaccine-preventable disease was 12%, generally similar by transplanted organ, except higher among lung recipients. Gastrointestinal diseases, tuberculosis, and legionellosis had excess cases among transplant recipients, although there were few sexually transmitted infections and vector-borne diseases.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>There is potential to avoid preventable infections among transplant recipients with improved vaccination programs, health education, and pretransplant donor and recipient screening.</jats:p>
</jats:sec>},
keywords = {Infectious Diseases, Oncology, SAFEBOD},
pubstate = {published},
tppubtype = {article}
}
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Infections, including common communicable infections such as influenza, frequently cause disease after organ transplantation, although the quantitative extent of infection and disease remains uncertain.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A cohort study was conducted to define the burden of notifiable infectious diseases among all solid organ recipients transplanted in New South Wales, Australia, 2000–2015. Data linkage was used to connect transplant registers to hospital admissions, notifiable diseases, and the death register. Standardized incidence ratios (SIRs) were calculated relative to general population notification rates, accounting for age, sex, and calendar year. Infection-related hospitalizations and deaths were identified.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Among 4858 solid organ recipients followed for 39 183 person-years (PY), there were 792 notifications. Influenza was the most common infection (532 cases; incidence, 1358 [95% CI, 1247–1478] per 100 000 PY), highest within 3 months posttransplant. Next most common was salmonellosis (46 cases; incidence, 117 [95% CI, 87–156] per 100 000 PY), then pertussis (38 cases; incidence, 97 [95% CI, 71–133] per 100 000 PY). Influenza and invasive pneumococcal disease (IPD) showed significant excess cases compared with the general population (influenza SIR, 8.5 [95% CI, 7.8–9.2]; IPD SIR, 9.8 [95% CI, 6.9–13.9]), with high hospitalization rates (47% influenza cases, 68% IPD cases) and some mortality (4 influenza and 1 IPD deaths). By 10 years posttransplant, cumulative incidence of any vaccine-preventable disease was 12%, generally similar by transplanted organ, except higher among lung recipients. Gastrointestinal diseases, tuberculosis, and legionellosis had excess cases among transplant recipients, although there were few sexually transmitted infections and vector-borne diseases.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>There is potential to avoid preventable infections among transplant recipients with improved vaccination programs, health education, and pretransplant donor and recipient screening.</jats:p>
</jats:sec>
2020
Rosales, Brenda M.; Mata, Nicole De La; Vajdic, Claire M.; Kelly, Patrick J.; Wyburn, Kate; Webster, Angela C.
Cancer mortality in kidney transplant recipients: An Australian and New Zealand population‐based cohort study, 1980–2013 Journal Article
In: Intl Journal of Cancer, vol. 146, no. 10, pp. 2703–2711, 2020, ISSN: 1097-0215.
Abstract | Links | BibTeX | Tags: Cancer Research, CELESTIAL, Oncology
@article{Rosales2019,
title = {Cancer mortality in kidney transplant recipients: An Australian and New Zealand population‐based cohort study, 1980–2013},
author = {Brenda M. Rosales and Nicole De La Mata and Claire M. Vajdic and Patrick J. Kelly and Kate Wyburn and Angela C. Webster},
doi = {10.1002/ijc.32585},
issn = {1097-0215},
year = {2020},
date = {2020-05-15},
urldate = {2020-05-15},
journal = {Intl Journal of Cancer},
volume = {146},
number = {10},
pages = {2703--2711},
publisher = {Wiley},
abstract = {<jats:p>Cancer burden is increasing in kidney transplant recipients, but differences in mortality compared to the general population remain unclear. We sought to compare cancer mortality in paediatric and adult kidney transplant recipients with the general population and describe any differences, by site, age and sex, country and over time. We included kidney transplant recipients from the Australian and New Zealand Dialysis and Transplantation Registry, 1980–2013. Date of death and underlying cause of death were ascertained by data‐linkage and classified using ICD10AM codes. Indirect standardisation was used to estimate standardised mortality ratios (SMR). There were 5,284 deaths in 17,628 kidney transplant recipients over 175,084 person‐years of observation, including 1,061 (20%) cancer deaths. Relative cancer mortality was higher than the general population for all‐site (SMR 2.9, 95% CI 2.7–3.1) cancer and highest for nonmelanoma skin cancer (SMR 50.9, 95% CI 43.5–59.6) and lymphoma (SMR 42.2, 95% CI 35.3–50.5). Relative cancer mortality decreased with increasing age in men (<jats:italic>p</jats:italic> < 0.001) and women (<jats:italic>p</jats:italic> = 0.001) but never reached parity with the general population. Relative mortality did not change with age for skin and lip, or colorectal cancers (<jats:italic>p</jats:italic>‐value >0.1). Only relative colorectal cancer mortality increased over time (<jats:italic>p</jats:italic> = 0.002). Our study shows cancer mortality in kidney transplant recipients was higher than expected in the general population. The magnitude of excess mortality varied by cancer site, age and sex. Further evidence is needed to identify whether this variation is due to differences at diagnosis or access and effectiveness of cancer treatments in this population.</jats:p>},
keywords = {Cancer Research, CELESTIAL, Oncology},
pubstate = {published},
tppubtype = {article}
}
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