Infections among pediatric transplant candidates: An approach to decision-making.
Bacteremia
/ complications
Bacterial Infections
/ complications
Central Nervous System Infections
/ complications
Child
Decision Making
Humans
Infections
Mycoses
/ complications
Organ Transplantation
/ methods
Patient Safety
Pediatrics
/ methods
Respiratory Tract Infections
/ complications
Risk
Transplants
Urinary Tract Infections
/ complications
Virus Diseases
/ complications
candidate
infection
pediatric
solid organ transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
11
07
2018
revised:
14
12
2018
accepted:
21
12
2018
pubmed:
7
3
2019
medline:
26
3
2020
entrez:
7
3
2019
Statut:
ppublish
Résumé
The presence of infections in the immediate pretransplant period poses challenges in decision-making. Delaying transplantation because of these infections may be required, but is associated with a risk to the potential recipient. The aim of this project was to develop a structured framework based on expert opinion to guide decision-making regarding the safety of transplantation for candidates with infection immediately before transplant, and to show how this framework can be applied to clinical scenarios. Categories were created as follows: Category A: no delay; Category B: brief delay (≤1 week); Category C: intermediate delay (>1 week); and Category D: more prolonged or indefinite delay. A survey containing 59 clinical scenarios was sent to members of the IPTA ID CARE committee. Answers were reviewed, and the level of agreement was characterized as follows: Level 1: ≥75% agreement; Level 2:51%-74% agreement; and Level 3: ≤50% agreement. 95% CIs were calculated for the mean overall agreement across 59 scenarios. Among the panel, the agreement level ranged from 33% to 92% with the mean overall agreement across the 59 scenarios being 61%. For 7/59 scenarios, the lower bound of 95% CI was greater than 50%, indicating a difference at the 5% level of significance between the observed proportion and the chance level of 0.5. The document provides expert opinion regarding the need to delay transplantation in the setting of different infections. The most important points in the decision to proceed to SOT included the urgency of transplantation and the severity of infection.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13375Informations de copyright
© 2019 Wiley Periodicals, Inc.