Internal Medicine · 3 h ago
Abdominal transplant recipients with sepsis had higher 30-day survival
A post hoc analysis of a prospective multicenter cohort compared 538 adults with sepsis, including 50 abdominal solid organ transplant recipients. Transplant recipients had higher 30-day survival and a distinct immune profile, but the observational findings do not establish why outcomes differed.
- 30-day survival was 84% in transplant recipients versus 66%.
- Adjusted mortality hazard was lower in transplant recipients.
- Immune markers showed attenuated inflammation and selected preserved innate readouts.
- Observational findings do not establish mechanisms or guide treatment.
Researchers conducted a post hoc analysis of the SepsisDataNet.NRW prospective multicenter cohort, which enrolled 538 adults with sepsis in five German intensive care units; 50 had a prior abdominal solid organ transplant and 488 did not. The team assessed clinical outcomes and profiled immune markers using cytokine assays, flow cytometry, proteomics and cellular signaling analyses. Additional exploratory analyses included a separate cohort of non-septic kidney transplant recipients.
Thirty-day survival was 84% among transplant recipients and 66% among non-transplant patients. After adjustment, transplantation was associated with a lower hazard of death (HR 0.49, 95% CI 0.26–0.95). Transplant recipients also had lower IL-6 and TNF-α, higher IL-18, and higher monocytic HLA-DR expression, alongside changes in proteomic and immunometabolic markers.
The results suggest that sepsis in abdominal transplant recipients is not characterized by uniform suppression across measured immune pathways. However, this was an observational post hoc analysis, and molecular measurements were available only in subsets of the cohort. The findings identify associations and possible mechanisms; they do not establish that the immune differences caused better survival or support changes to sepsis management.
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Intensive Care Medicine: Immunological signatures of sepsis in abdominal solid organ transplant recipients: A multilayer and multicentric prospective cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.