Influencing factors for perioperative diarrhea in recipients after deceased-donor kidney transplant

Objective To explore the related factors of perioperative diarrhea in cadaveric renal transplant recipients. Methods A case-control trial was conducted on 545 recipients receiving cadaveric renal transplantation in the Affiliated Hospital of Guizhou Medical University from July 2017 to December 2021. Their clinical data during perioperative period were collected, and then all recipients were divided into the diarrhea group (n=207) and non-diarrhea group (n=338). Their age, gender, body mass index (BMI), duration of operation, dialysis types, type 2 diabetes or not, immune induction regimen, mycophenolic acid (MPA) types, infection prevention regimen, preoperative enema, and occurrence of delayed graft function (DGF) were observed and recorded. Multivariate stepwise logistic regression analysis was used to analyze the factors related to the perioperative diarrhea in these recipients. Results The incidence of perioperative diarrhea was 37.98% (207/545). The occurrence time of diarrhea was in 5.90±6.94 d after transplantation, and 71.98% (149/207) of diarrheal patients occurred within 3 d. Univariate analysis showed that significant differences were observed in age, gender, BMI, type 2 diabetes, immune induction regimen, antibiotic prevention regimen, preoperative enema, and post-operative DGF occurrence between the diarrhea and non-diarrhea groups. Multivariate stepwise logistic regression analysis indicated that overweight(OR=1.074, 95%CI: 1.011~1.141), male (OR=1.596, 95%CI: 1.032~2.470), post-operative DGF (OR=3.001, 95%CI: 1.712~5.260) and use of piperacillin after transplantation (OR=3.119, 95%CI: 1.918~5.074) were independent risk factors for perioperative diarrhea in cadaveric kidney transplant recipients. Conclusion Overweight, male, DGF and piperacillin use after transplantation may be the risk factors of perioperative diarrhea in cadaveric transplant recipients.