Infection Patterns and Survival Among Renal Transplant Recipients

The outcome of kidney transplantation is determined by multiple factors and infections represent one of the major factors affecting graft and patient survival. Recent COVID-19 pandemic have adversely affected the transplant population. Very little data is available on post-transplant infections and patient survival from India. In this retrospective observational study, data related to post-transplant infections from patients who had undergone renal transplantation between October 2014 and October 2021 were collected. A total of 255 infections episodes were observed in 118 patients. Bacterial infections were the most common (55%) followed by viral (35%), fungal (5%), mycobacterial (4%), and parasitic (1%). The most common bacterial and viral infections were urinary tract infections (70.5%) and COVID-19 (56%), respectively. BK virus and COVID-19 were associated with increased graft loss (p < 0.05). The majority of deaths due to infections were related to COVID-19 infection (71.42%). Kaplan-Meier survival analysis showed 1-, 3-, and 5-year patient survival of 98.23%, 96.36%, and 92.90% and graft survival of 98.14%, 95.97%, and 91.78, respectively. Infections with their adverse impact remain a concern in kidney transplant patients. Comparable patient and graft survival to the Western data despite the high infection burden and the COVID-19 pandemic suggests that effective management can reduce the impact of infections on survival.