21 January 2025 : Original article
A New Routine Immunity Score (RIS2020) to Predict Severe Infection in Solid-Organ Transplant Recipients
Elizabeth Sarmiento
ABCDEF 1,2, Ikram Ezzahouri BEF 1,3, Maricela Jimenez-Lopez ABEF 1, Kristofer M. Limay Carré BCDE 1, Rocio Alonso B 1,3, Carlos Ortiz-Bautista B 4,5,6, Magdalena Salcedo Plaza B 7, Maria Luisa Rodríguez-Ferrero B 8, Pedro Martin Padilla-Machaca B 9, Ana Cerron B 9, Jose Carlos Chaman BD 9, Ana P. Vionnet Salvo B 3,10, Javier Carbone ABCDEFG 1,3,10,11,12*
DOI: 10.12659/AOT.946233
Ann Transplant 2025; 30:e946233
Table 2 Clinical and laboratory parameters associated with the risk of severe infections.
| Parameters | HR | 95% CI | P value |
|---|---|---|---|
| Type of transplant | 0.77 | 0.55–1.09 | 0.14 |
| Age (per each year increase) | 1.0078 | 0.99–1.03 | 0.38 |
| Age >50 years | 1.1190 | 0.71–1.77 | 0.63 |
| Sex (women vs men) | 1.1202 | 0.71–1.77 | 0.63 |
| Basiliximab induction (yes vs no) | 0.9921 | 0.43–2.27 | 0.98 |
| Time on transplant waiting list (per each day increase) | 0.9992 | 0.99–1.004 | 0.19 |
| Mean cold ischemia time (pear each minute increase) | 1.0007 | 0.99–1.0019 | 0.207 |
| Time to discharge after transplant (per each day increase) | 1.0043 | 0.99–1.01 | 0.13 |
| Time to discharge >26 days after transplant | 1.939 | 1.201–3.128 | 0.007 |
| Obesity (yes vs no) | 0.9158 | 0.54–1.54 | 0.74 |
| Diabetes (yes vs no) | 1.36 | 0.79–2.34 | 0.26 |
| Dyslipidemia (yes vs no) | 1.0429 | 0.67–1.62 | 0.85 |
| Smoking (yes vs no) | 9.9594 | 0.62–1.47 | 0.85 |
| Ischemic heart disease (yes vs no) | 0.8124 | 0.53–1.25 | 0.35 |
| Ferritin levels before transplant (per each increase) | 1.0001 | 0.99–1.0004 | 0.53 |
| Vitamin D before transplant (per each decrease) | 1.0113 | 0.96–1.06 | 0.65 |
| Lymphocyte count before transplant (per each decrease) | 1.0055 | 0.97–1.0358 | 0.72 |
| Albumin before transplant (per each decrease) | 1.1265 | 0.63–2.009 | 0.68 |
| Acute rejection during 6-month follow-up | 1.04 | 0.62–1.73 | 0.88 |
| Lymphocytes at day 7 (per each decrease) | 1.0160 | 0.93–1.11 | 0.71 |
| Lymphocytes at day 30 (per each decrease) | 1.0103 | 0.97–1.05 | 0.59 |
| Albumin at day 30 (per each decrease) | 1.0920 | 0.56–2.12 | 0.79 |
| IgG <600 mg/dL at days 7 or 30 | 2.07 | 1.37–3.12 | 0.0005 |
| CD4 <400 cells/uL at day 30 | 1.76 | 1.03–3.04 | 0.039 |
| C3 <80 mg/dL at day 30 | 2.18 | 1.16–4.06 | 0.014 |
| C-reactive protein >3 mg/dL at day 30 | 2.11 | 1.12–3.97 | 0.02 |
| RIS2020 ≥4 | 5.18 | 3.06–8.75 | <0.001 |
| RIS – routine immunity score; HR – hazard ratio; CI – confidence interval. | |||