Declining trend of infections in renal transplant recipients in a tertiary care hospital from India

Abstract

Introduction: Infections are an important cause of morbidity and mortality in renal transplant recipients. This retrospective study was done to study the infection profile in renal transplant recipients. Materials and Methods: Seventy-three patients who developed infections out of 144 renal transplant recipients at a tertiary care center in southern India between January 2010 and June 2014 were studied. Infections were analyzed in terms of incidence, time of onset after transplant, clinical presentation, diagnosis, graft dysfunction, and patient and graft survival. Results: A total of 145 infection episodes were documented in the 73 patients studied. Majority (79.5%) were males and females constituted 20.5%. Predominant age group involved was 21–30 years (38.4%). Most common donor was mother (30.1%). Induction therapy was given in 21 (28.8%) patients. Mean duration of follow-up was 21.3 months. Most common infections were those of urinary tract (34.5%), followed by viral (31.2%), sepsis (15.2%), mycobacterial (9.7%), and fungal (6.2%). Parasitic infections (giardiasis and Strongyloides hyperinfection syndrome) occurred in 2 (1.4%) patients. Cytomegalovirus accounted for 14.5% and BK virus for 5.5% of total infections. Majority (77.1%) of the infection episodes occurred in the first 6 months of transplantation. There were 11 (7.6%) episodes of graft dysfunction and three patients had graft failure. A total of nine deaths were recorded due to these infections. Conclusion: Urinary tract is the most common source of infection in renal transplant recipients, followed by viral infections. Understanding the chronologic pattern of these infectious episodes facilitates early diagnosis and management of patients.

Keywords

• Anti-rejection therapy
• diabetic status
• infections
• renal transplant recipients
• risk factor profile