Incidence and outcomes of fever of unknown origin after kidney transplant in the modern era

• DOI: 10.1111/ctr.15217
• Publication Date: 2023-12-11T18:47:20Z
• Authors: Margaret R. Jorge...; Sandesh Parajuli; Hanna L. Kleiboeker; Daniel C. Felix; Brad C. Astor; Christopher M. Sa...; Jeannina A. Smith; Didier A. Mandelbrot
• Keywords: Etiology

Abstract Background While presumably less common with modern molecular diagnostic and imaging techniques, fever of unknown origin (FUO) remains a challenge in kidney transplant recipients (KTRs). Additionally, the impact FUO on patient graft survival is poorly described. Methods A cohort adult KTRs between January 1, 1995 December 31, 2018 was followed at University Wisconsin Hospital. Patients transplanted from to 2005 were included “early era”; patients 2006 “modern era”. The primary objective describe epidemiology etiology diagnoses over time. Secondary outcomes rejection, survival. Results There 5590 transplants our center during study window. identified 323 an overall incidence rate .8/100 person‐years. Considering only first 3 years after transplant, significantly lower era than early era, Incidence Rate Ratio (IRR) per 100 person‐years .48; 95% CI: .35–.63; p < .001. total 102 (31.9%) had determined within 90 days diagnosis: infectious, two malignancies. In remained associated rejection (HR = 44.1; 16.6–102; .001) but not failure 1.21; .68–2.18; .52) loss 1.17; .85–1.62; .34), or death .79–1.76; .43. Conclusions: era. Our suggests infection most etiology. significant increases risk warranting further inquiry into management immunosuppressive medications SOT setting FUO.