{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:28:32Z","timestamp":1770899312208,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"DOI":"10.13039\/501100018935","name":"Universit\u00e4tsklinikum Erlangen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018935","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Med Klin Intensivmed Notfmed"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with chronic kidney disease who undergo kidney transplantation are at risk of acute illness, acute graft failure, and intensive care admission in the years following transplantation. To identify individual risk factors, assess the effect of immunosuppression, and evaluate outcomes including loss of graft function in a\u00a0European setting, we analyzed 266 intensive care unit (ICU) admissions of kidney transplant recipients (KTRs) with severe illness between 2005 and 2019. Admission to the ICU occurred predominantly 12\u00a0months or later after transplantation, with a\u00a0median time of 52.7\u00a0months. Overall mortality was 12.8% and was associated with infections in 70.6% of cases. Acute immunosuppressive therapy for rejection, rather than primary induction or immunosuppressive regimens, correlated with critical illness in 53% of cases. The median time to ICU admission was 1.2\u00a0years. Of the survivors, 12.1% lost graft function and remained on dialysis at discharge. In univariate and multivariate analyses, we found that SAPS (Simplified Acute Physiology Score)\u00a0II values and vasopressor use were significantly associated with mortality. Overall, KTRs are at risk of critical illness, especially beyond 1\u00a0year post-transplant. Rejection therapy and older age increase the risk of critical illness.<\/jats:p>","DOI":"10.1007\/s00063-026-01407-8","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:42:50Z","timestamp":1770896570000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The burden of critical illness in kidney transplant recipients\u2014beyond 1\u00a0year post-transplant","Kritische Erkrankungen bei Nierentransplantatempf\u00e4ngern \u2013 Intensivmedizinische Aufnahmen nach einem Jahr"],"prefix":"10.1007","author":[{"given":"Katrin","family":"Sturm-Koch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Bihlmaier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Hilgers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Schiffer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Herbst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2867-945X","authenticated-orcid":false,"given":"Carsten","family":"Willam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"1407_CR1","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1016\/j.transproceed.2021.01.031","volume":"53","author":"N Abrol","year":"2021","unstructured":"Abrol\u00a0N, Kashani\u00a0KB, Prieto\u00a0M et\u00a0al (2021) A Descriptive Study of Late Intensive Care Unit Admissions After Adult Solitary Kidney Transplantation. 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All studies mentioned were in accordance with the ethical standards indicated in each case.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Local Ethics Comitee under the reference 22-388-Br.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}