Kidney Transplant Recipients: Viral Infections and Malignancies

Area of Science:

• Nephrology
• Transplant Immunology
• Infectious Diseases

Background:

• Kidney transplant recipients (KTRs) face risks of infections and malignancies due to immunosuppression, impacting graft health.
• These complications can lead to allograft dysfunction and poorer clinical outcomes.

Purpose of the Study:

• To determine the prevalence of viral infections and post-transplant malignancies in hospitalized KTRs.
• To identify factors linked to acute kidney injury (AKI) and chronic graft dysfunction in this population.

Main Methods:

• A prospective observational study of 215 adult KTRs over one year.
• Analysis of clinical data, malignancy history, and viral detection (BK polyomavirus, CMV, EBV, parvovirus B19).

Main Results:

• AKI affected 65.6% and chronic graft dysfunction 21.4% of patients.
• Viral positivity (BKV, CMV most common) was found in 16.7%; infections were the primary AKI cause.
• Viral positivity independently predicted AKI (aOR 3.01) and, with malignancy history and AKI, predicted chronic graft dysfunction.

Conclusions:

• Viral reactivation and malignancy history are associated with increased graft vulnerability in hospitalized KTRs.
• Integrated assessment of infectious, immunologic, and clinical factors can enhance risk stratification and management for KTRs with acute illness.