Infectious complications in renal transplant recipients

Despite improved outcomes in kidney transplant patients over the years, infectious complications remain a significant cause of morbidity and mortality in this population. Infection is now more common than acute rejection and associated with poor graft and patient outcomes. Several studies have shown that allograft and patient survival were reduced at 1 and 3 years after transplantation in recipients with infection and febrile episodes, and even in the current era infection remains the third largest cause of death in renal transplant recipients. Approximately two-thirds of renal transplant recipients will experience an infectious–related complication in the first year after transplantation and approximately 20% eventually will die from infection. These alarming rates reflect the overall or “net state” of immunosuppression associated with end-stage renal disease (ESRD) and transplantation as well as donor and environmental exposures. In addition, the robustness of a recipient's immune system depends on several factors including age, nutrition, and comorbid conditions.