663 Potential for Prophylactic Antibiotics in Renal Transplantation: A Retrospective Study of Kidney Perfusion Fluid Cultures and Kidney Cold Ischaemic Time

Abstract Aim Infection is a significant cause of morbidity in kidney transplantation, and it is believed that an increased cold ischemic time is an independent risk factor. Identification of common pathogens in perfusion fluids, as well as the safe limit of cold ischaemic time can be used to reduce the risk of postoperative complications. There are currently no guidelines for prophylactic antibiotics. Method This is a retrospective review of the microbiological analysis of kidney perfusion fluids samples for a recipient transplant between 2017–2020. 100 patients were identified in this time period and this data was compared against the cold ischaemic time of the donor kidney. Results 23% (22/96) samples were positive for bacteria with the majority being gram positive cocci. The most common bacteria grown was Coagulase Negative Staphylococcus (44% - 11/25). However, a broad spectrum of bacteria was grown including Hafnia, Pseudomonas, Klebsiella, Kocuria and E-coli. 3% (3/96) of samples grew two different species of bacteria. The mean cold ischemic time for all transplants was 799 minutes with a range of 281–1618 minutes. The mean for infected samples was 935 mins with a range of 645–1410. Samples that grew 2 bacteria had a range of 913–941 mins. Conclusions There is potential to reduce the risk of infection with the use of broad-spectrum induction antibiotics and it is important that potential bacterial species and common resistance profiles are covered. There is a possible correlation between increased cold ischaemic time and bacterial growth in perfusion fluid however further research is warranted.