POS-728 Infectious Complications Following Kidney Transplantation and Their Influence On Kidney Graft Survival

Abstract

The potent immunosuppressive therapy given to prevent graft rejection in kidney transplant recipients results in an increased susceptibility to a wide range of opportunistic infections including bacterial, viral and fungal infections. This is a retrospective and descriptive study wich was conducted in the nephrology department: Kidney transplant unit, at the Fattouma Bourguiba hospital in Monastir. From 2008 to 2019, 103 patients have undergoine kidney transplantation. The incidence of infectious complications was 90.3%. The viral infections included: CMV infection was the: 29.1% including 80% of cases between the first and the sixth month after transplantation. BK virus infection was noted in a single case during the second year post transplant. Viral herpes: 4.9% of patients between the sixth month and one year after the transplant. A varicella zoster virus infection: 7.8% including 62.5% of cases during the second year. The pre-transplant status of the recipient: Ig G negative: CMV: 15.5%, EBV: 44.7%, HSV: 55.3%. No case of R- / D + was noted. The bacterial infections were: urinary tract infection: 4.9%, of which 42.9% occurred between the first and the sixth month. Community pneumonia: 36.9% including 8% after the sixth month. Pulmonary tuberculosis: 1.9% after the first year. Fungal infections: candidiasis: 5.8%: one case during the first year and 2 cases between the first and the sixth month. 2 cases were noted after the first year: One case of systemic candidiasis and one case of candidiasis oro- pharyngeal. Skin mycosis infection: 5.8% including 83.3% after the first year. Parasitic infections: 3.9%: 3 cases of diarrhea (Entamebea histolytica or Trichomonas intestinalis). A case of cutaneous leishmaniasis was observed after the first year of transplantation. * An overall estimate of renal survival after infectious complications was 67.4 months. Graft survival at 1, 5 and 10 years was estimated to 85%, 46% and 17% respectively. An overall estimate of patient survival after infectious complications was 55.1 months. The incidence of infectious complications, compared with the general population and the pre-transplant status of the recipient, increases substantially following kidney transplantation, causing significant morbidity and mortality. It had a potential impact on graft survival. It lead to graft dysfunction in the majority of cases.