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Table 1 Characteristics of individual recipients and their perioperative period

From: Single mutidrug resistant enterobacteriacae donor-derived infection in four solid organ transplant recipients: a case report

number of patient

age/sex/BMI

age/sex/BMI transplanted organ

principal disease

prior to SOT hospitalization/ATB therapy

immunological risk

immunosuppression

antibiotic prophylaxis

complication

therapy

antibiotic therapy

LOS [days]

outcome

1

60/male/26.6

kidney

chronic kidney disease, diabetic nephropathy, kidney transplantation 4 years ago, early graftectomia due to renal vein thrombosis, cardiac anamnesis: tricuspid valve repair due to regurgitation, atrial fibrillation (warfarine), EF LV 50%), habitual hypotension (midodrine), hemodialysis (AV shunt)

no/no

high 2nd kidney transplantation, PRA act 0%, max 14%

thymoglobuline and methylprednisolone (induction), thymoglobuline, tacrolimus, mycophenolate mofetil, prednisone, withdrawal on the 3rd day

cefuroxime (2 days)

early hemodynamic instability, left heart insuficiency, arythmia, sepsis, visceral ischemia

surgery, inotropes, antiarythmics, therapy of the septic shock acording to guidleines, CVVHD, mechanical ventilation for 48 h

since 2nd postoperative day meropenem 2 g á 8 h, amikacin 2 g á 24 h

3

death on the 2nd day after SOT, sepsis, multiorgan failure

2

32/male/25.1

kidney

chronic kidney disease, chronic glomerulonephritis, previous 2 kidney transplantations, peritoneal dialysis, 2 episodes of peritonitis

no/no

high high level of DSA, PRA act 36%, max 79% plasmapheresis before the transplantation

thymoglobuline (3 doses), intravenous immunoglobuline (3 doses), tacrolimus, mycophenolate mofetil, prednisone

cefuroxime (2 days)

haemorrhage, strangulated sigma loop around CAPD catether, haemorrhagic shock

surgery, therapy of circulatory shock, CVVHD, mechanical ventilation for 52 h

since 2nd postoperative day meropenem 2 g á 8 h, metronidazole 500 mg á 8 h

4

death on the 3th day after SOT, sepsis, multiorgan failure

3

49/male/23.1

liver

HCV related liver cirrhosis Child-Pugh C, portal hypertension, hepatorenal syndrome, ascites, encephalopathy

yes/yes

low, PRA 0%

methylprednisolone (induction), tacrolimus, mycophenolate mofetil, prednisone

piperacilin/tazobactam (3 days)

none

usual postoperative care, early extubation

since 3rd postoperative day meropenem 1 g á 8 h (for 10 days)

22

alive (2018) with good graft function

4

59/female/25.8

pancreas islets

labile diabetes mellitus type I, daily episodes of hypoglycemia, chronic kidney disease, cholestasis of the liver

no/no

low, PRA act 0%, max 13%

thymoglobuline and methylprednisolone (induction), tacrolimus, rapamycine – with drawal on the 2nd day

piperacilin/tazobactam (3 days)

haemorrhage, pneumonia, haemorrhagic and septic shock, acute kidney injury and multiorgan failure

several surgeries, therapy of circulatory shock, CVVHD, intermitent dialysis, mechanical ventilation for 540 h, tracheostomy

piperacilin/tazobactam 2,25 g á 6 h, on the 4th postoperative day changed to meropenem 1 g á 6 h, amikacin acording to serum level (for 10 days)

81

alive (2018), early failure of the transplanted islets, 2nd successfull islets transplantation in 2018

5

40/male/28.4

heart

dilatation cardiomyopathy, EF LV < 20%, pulmonary hypertension, ICD, chronic kidney disease

yes/yes

low, PRA 0%

thymoglobuline, methylprednisolone, and mycophenolate mofetil (induction), thymoglobuline, tacrolimus, methylpredisolone, mycophenolate mofetil

cefriaxone (3 days)

none

usual postoperative care, mechanical ventilation for 13 h

since 2nd postoperative day meropenem 1 g á 6 h (for 10 days)

40

alive (2018), good graft function