Incidence Rate of Catheter-Related Bloodstream Infection After Solid-Organ Transplant: A Single-Center Experience

Background: Catheter-related bloodstream infections (CRBSI) incidence is well-studied in general hemodialysis patients. There is a lack of data on CRBSI rates specifically in solid organ transplant (SOT) recipients requiring hemodialysis. This study aims to investigate CRBSI incidence in this population at a single center. Methods: This retrospective, single-center cohort study at Massachusetts General Hospital (MGH) investigated CRBSI incidence in non-kidney SOT (i.e., heart, lung, liver) who required hemodialysis (HD) via a tunneled dialysis catheter (TDC) between January 2016 and October 2024. EMR data was utilized to identify adults aged ≥18 who underwent non-kidney SOT and developed renal failure requiring TDC-based HD. Results: 42 individuals met our inclusion criteria. The mean age of this cohort was 57 years, 50% were male, and 81% were White. The group consisted of 17 liver transplant recipients (40.5%), 13 heart transplant recipients (31.0%), and 12 lung transplant recipients (28.6%). None of the heart or liver transplant recipients received antibody induction therapy while 8 lung recipients received basiliximab induction, and 4 received no induction therapy. 97% of the patients received mycophenolate mofetil, tacrolimus, and prednisone, while 3% received steroid-free maintenance. The median follow-up was 51.5 days (interquartile range 16-233). During this period, 6 individuals developed CRBSI, resulting in an incidence rate of 0.86 infections per 1000 catheter-days. No deaths were attributed to CRBSI. Conclusion: Our findings suggest that immunosuppression in the setting of SOT is not associated with an increased risk of CRBSI in patients with renal failure utilizing TDCs especially when a consistent and standardized protocol for the access and care of these catheters is utilized.