Epidemiology of surgical site infections after solid organ transplants in the period 2015-2019: A single-center retrospective cohort study.


Surgical site infections (SSI) are severe complications of solid organ transplant (SOT). This retrospective study assessed the epidemiology of and outcomes associated with invasive primary SSI (IP-SSI) occurring within 3 months of transplantation in adult SOT recipients at Duke University over a 5-year period (2015-2019). Among 2073 consecutive SOT recipients, 198 IP-SSI were identified. The IP-SSI rate declined over the period (14.4% in 2015 vs. 8.3% in 2019) and was higher among multi-organ compared with single-organ transplants (33.9% vs. 8.1%, p < .01). SOT recipients with IP-SSI had longer hospital stays than patients without SSI (30.0 vs. 17.0 days, p < .01). Transplant hospitalization (9.6% vs. 2.2%, p < .01), 6-month (11.6% vs. 3.3%, p < .01), and 1-year mortality (15.7% vs. 5.8%, p < .01) were higher in SOT recipients with IP-SSI than in those without. While Gram-positive bacteria were the most common pathogens, urogenital Mollicute and atypical Mycobacteria were identified as an unexpected cause of IP-SSI, particularly among lung transplant recipients. The median time to IP-SSI was 24.0 (IQR 13.8-48.3) days, although the time to IP-SSI varied based on organ transplanted and the causative pathogen. IP-SSI is an important and potentially modifiable complication of SOT, associated with prolonged hospitalizations and reduced survival, particularly in the lung transplant population.





Published Version (Please cite this version)


Publication Info

Carugati, Manuela, Sana Arif, Debra Lynn Sudan, Bradley Henry Collins, John Carroll Haney, Jacob Niall Schroder, John Michael Reynolds, Sarah Stamps Lewis, et al. (2022). Epidemiology of surgical site infections after solid organ transplants in the period 2015-2019: A single-center retrospective cohort study. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 10.1111/ajt.17189 Retrieved from https://hdl.handle.net/10161/26020.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Manuela Carugati

Associate Professor of Medicine

Sana Arif

Assistant Professor of Medicine

Debra L Sudan

Professor of Surgery

I am interested clinically in all abdominal organ transplants (kidney, liver, pancreas and intestine).  I am specifically interested in intestine transplantation and improving intestine graft preservation and long-term graft function and patient survival.  In addition, I am interested in monitoring of patients to improve our ability to determine the etiology of graft dysfunction when there are complex interacting issues such as infection and rejection as well as examining better immunosuppressive regimens to maintain excellent graft function.  We have numerous research studies and trial to improve our knowledge in these areas and thereby contribute to improved patient outcomes!


Bradley Henry Collins

Associate Professor of Surgery

(1) The laboratory's primary focus is the study of the feasibility of transplanting porcine islets into primates as a treatment for type 1 diabetes mellitus. There is a severe shortage of human cadaveric pancreas donors for the 1 to 2 million type 1 diabetics in the United States. The use of human islets would further exacerbate the problem as 2 or 3 pancreases are required per recipient. In collaboration with Dr. Emmanuel Opara, an islet cell physiologist, we have purified islets from porcine pancreases, placed the islets in microcapsules, and transplanted the islets into diabetic baboons without the use of immunosuppression. Our goal is to demonstrated the utility of this system as a pre-clinical model.

(2) Recently, my laboratory has developed an interest in senescence of the liver. The project is a collaborative effort with hepatologist Dr. Don Rockey. We induce cirrhosis in young and old mice with carbon tetrachloride and then extract the intrahepatic lymphocytes. FACS technology is used to identified the lymphocyte populations and then sort them. The cytokine profile is then elucidated. We plan to use gene chip technology to assess the gene expression.


Jacob Niall Schroder

Assistant Professor of Surgery

John Michael Reynolds

Professor of Medicine

Sarah Stamps Lewis

Associate Professor of Medicine

Michael Yarrington

Assistant Professor of Medicine

Rachel Ann Miller

Professor of Medicine

Barbara Dudley Alexander

Professor of Medicine

Clinical research related to infectious complications of solid organ and bone marrow transplantation, with a particular interest in the treatment and rapid diagnosis of fungal disease. Training the next generation of Transplant Infectious Disease Physicians is a special focus of mine as the Principal Investigator of our Interdisciplinary T32 Training Program funded the NIH. 

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.