ABSTRACT
Introduction: Kidney transplant recipients (KTRs) have to receive lifelong immunosuppressive therapy. Consequently they are predisposed to life threatening infections. Even though the data on infectious pathologies have been described in KTRs, the data on long term sequalae of such diseases is lacking. Methods: In this single high volume centre we followed up 100 KTRs, who presented to us with signs of infections. Patients presenting with acute drug reaction or toxicity, malignancy, and auto-immune disorders were excluded. Results: Majority of the patients were male (80%) with a median age of 47years and the median duration of follow up is 34 months. Comorbidites were present in majority of patients in the form of hypertension (83%), Diabetes (11%), heart disease (7%). Amongst infections prior to kidney transplant, TB (28%), HCV (11%) and HBV (1%) were the predominant. 33% patients had acute graft dysfunction, which on biopsy showed mostly ATN and was managed conservatively. However one patient had features of CMV viremia, which was managed with iv Valganciclovir. During follow up 57% of patients presented to us with at least one episode of infection, while 24% patients had 3 more episodes of infection during the follow up period. First episode of infection occurred after a median duration of 10 months. The most common infections were UTI (40%), acute gastroenteritis (35%), CMV infections (10%),pyelonephritis (5%), bacterial pneumonia (5%) protozoal infections (2%), COVID (2%). Most of the infections were managed successfully however 10% patients had graft dysfunction and are on maintenance hemodialysis. Conclusions: Infections in KTRs are a serious debilitating condition which affect graft function. Prompt and aggressive treatment is warranted for graft survival. No conflict of interest