Immunosuppressive therapy management during sepsis in kidney transplant recipients: a prospective multicenter study
Authors' conclusion
This study is the first prospective investigation to suggest an association between MPA discontinuation and adverse outcomes during sepsis in critically-ill KTRs.
Study context
- Population
- Kidney transplant recipients transplanted ≥3 months, admitted to the Intensive Care Unit (ICU) for sepsis, 11 French ICUs
- Participants
- 124 recipients · 11 French ICUs
- Exposure
- Immunosuppressive therapy discontinuation vs continuation during sepsis
- Outcome
- MAKE 180: composite of mortality, kidney graft dysfunction and dialysis requirement
- Follow-up
- 180 days after inclusion
Methodological detailsmulticentre, multivariable analysis
- Multicentre
- Multivariable analysis
Main finding
As reported in the abstract
MAKE 180 · 180 days
Each group vs CNI continuationAdjusted odds ratio (95% CI)P value
CNI discontinuationadjusted for age, non-renal SOFA, kidney function at admission, sex, history of cellular rejection
1.05(0.87–1.26)
P = 0.6MPA discontinuation
1.45(1.07–1.96)
P = 0.018Observational data: associations, not effects.
Further findings
ICU-acquired infections
| aOR (95% CI) | P value | ||
|---|---|---|---|
| IST discontinuation | 1.14 (0.95–1.36) | P = 0.157 | |
| 0.512Adjusted odds ratio (log scale) |
Safety
Graft rejection among ICU survivors · year following ICU discharge
- Graft rejections
- 2
Original publication
Immunosuppressive therapy management during sepsis in kidney transplant recipients: a prospective multicenter study. Ann Intensive Care. Published 10 August 2025. doi:10.
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