Infectious Complications in Kidney Transplantation

Kidney transplantation is associated with lower risk for infection than other solid organ transplantations, reflecting the elective nature of kidney transplantation and clinical and nutritional status of recipients. Infection, however, remains a significant cause of morbidity and mortality in renal transplant recipients. Infections related to transplant surgical complications, acquisition of health care-associated pathogens, and reactivation of latent disease can affect graft function and transplant outcome. Graft dysfunction or chronic rejection leads to augmented immunosuppression, increasing the risk for infection with immunomodulating viruses. Although rare, donor-derived infections can arise by delayed donor seroconversion of unidentified pathogens in the organ donor at the time of organ procurement. Despite prophylactic therapy against common pathogens; infections are the second most common cause of death after cardiovascular disease in renal transplant recipients. According to the U.S. Renal Data System (USRDS), infections occurred at a rate of 45 per 100 patient-years during the first 3 years after transplantation (Snyder et al., 2009).