{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T12:45:23Z","timestamp":1789908323518,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T00:00:00Z","timestamp":1494288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease\u2010free survival after renal transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 112 of 957 kidney transplant recipients (<jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s) with sepsis. In all, 31 <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s developed severe sepsis or septic shock, and 30 <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s died from sepsis. <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s without sepsis were used for comparison. <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010specific and alloreactive T cells were measured using an interferon\u2010\u03b3 Elispot assay. The extent of immunosuppression was quantified by lymphocyte subpopulations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five\u2010year patient survival was 70.3% with sepsis compared to 88.2% without (<jats:italic>P<\/jats:italic>&lt;.001). Five\u2010year estimated glomerular filtration rate was lower in <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s developing sepsis (<jats:italic>P<\/jats:italic>&lt;.001). Upon multivariate analysis, diabetes, lymphocyte\u2010depleting induction, donor age, <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> replication, and acute rejection increased the risk of sepsis (<jats:italic>P<\/jats:italic>&lt;.05). Age, diabetes, underweight\/obesity, and pneumonia as site of infection were predictive factors of mortality (<jats:italic>P<\/jats:italic>&lt;.05). Early\u2010onset sepsis was associated with decreased <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>3+ and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4+ T cells pre\u2010transplantation (<jats:italic>P<\/jats:italic>&lt;.05). Impaired <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010specific cellular immunity pre\u2010transplantation was associated with <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> replication and early\u2010onset sepsis (<jats:italic>P<\/jats:italic>&lt;.05). High frequencies of alloreactive T cells were associated with acute rejection, lymphocyte\u2010depleting rejection treatment, and early\u2010onset sepsis (<jats:italic>P<\/jats:italic>&lt;.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s developing sepsis show inferior patient survival and allograft function. Identified risk factors and differences in lymphocyte counts, <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010specific immunity, and alloreactivity may prove useful to identify <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s at increased risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12695","type":"journal-article","created":{"date-parts":[[2017,3,11]],"date-time":"2017-03-11T14:36:40Z","timestamp":1489243000000},"source":"Crossref","is-referenced-by-count":27,"title":["Sepsis after renal transplantation: Clinical, immunological, and microbiological risk factors"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-4798","authenticated-orcid":false,"given":"Thomas","family":"Schachtner","sequence":"first","affiliation":[{"name":"Department of Nephrology and Internal Intensive Care Charit\u00e9 University Medicine Berlin Campus Virchow Clinic  Berlin Germany"},{"name":"Berlin\u2010Brandenburg Center of Regenerative Therapies (BCRT)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maik","family":"Stein","sequence":"additional","affiliation":[{"name":"Berlin\u2010Brandenburg Center of Regenerative Therapies (BCRT)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Reinke","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Internal Intensive Care Charit\u00e9 University Medicine Berlin Campus Virchow Clinic  Berlin Germany"},{"name":"Berlin\u2010Brandenburg Center of Regenerative Therapies (BCRT)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/138945007780362746"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra064928"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.5.1077"},{"issue":"4","key":"e_1_2_9_5_1","first-page":"1","article-title":"Amercian Society of Transplantation. 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