Outcomes and Mortality in Renal Transplant Recipients Admitted to the Intensive Care Unit

• Despite advances in pharmacological management and immune modulation, which have resulted in higher one-year survival rates, the long-term survival of renal transplant recipients has failed to improve.
• We evaluated all consecutive renal transplant recipients admitted to our ICU between July 2012 and July 2013, comparing their outcomes with those of a control group of non-transplant patients at the same period.
• The mortality of our study was 21%, without difference between recipient and non-recipient patients, even when the groups postoperative and clinical were compared separately.
• In multivariate model, requiring mechanical ventilation and hemodialysis were independently associated with mortality

IntroductionIn the intensive care unit (ICU), mortality is considered higher among renal transplant recipients than among nontransplantation patients. However, data regarding severe complications after kidney transplantation are scarce.Materials and MethodsIn this study, we evaluated all consecutive renal transplant recipients admitted to our ICU between July 2012 and July 2013 (n = 70), comparing their outcomes with those of a control group of nontransplantation patients admitted during the same period (n = 153). Among the transplant recipients, we compared survivors and nonsurvivors to identify predictors of ICU mortality.ResultsThe mean age of the transplant recipients was 52 ± 13 years. Of the 70 transplant recipients, 18 (25%) required mechanical ventilation, 28 (40%) required inotropic support, and 27 (39%) required hemodialysis, all of which are factors that worsen the prognosis significantly. Twenty-two (31%) of the transplant recipients died in the ICU and 17 (24%) died within 30 days after ICU discharge, rates similar to those observed for the control group.ConclusionsWe observed similar mortality between recipient and control groups, albeit the mortality was higher in the clinical group. In the multivariate model, the need for mechanical ventilation and the need for hemodialysis were independently associated with mortality.