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REVIEW ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 5  |  Page : 57-64

Opportunistic infection in renal transplant recipients


1 Associate Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Science, Rai Barielly Road, Lucknow, Uttar Pradesh 226014, India
2 Senior Resident, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Science, Rai Barielly Road, Lucknow, Uttar Pradesh 226014, India

Correspondence Address:
Anupma Kaul
Associate Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Science, Rai Barielly Road, Lucknow, Uttar Pradesh 226014
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.ijt.2014.01.012

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Despite improvements in the immunosuppressive protocols, and infection preventive method infections remains a major impediment to long-term renal graft survival especially in developing countries. Opportunistic infections after renal transplant usually follow a time table pattern with highest risk during first 6 month when intensity of immunosuppression is maximum, although this was not uniformly found in patients from this continent. In renal allograft recipient, immunosuppressive drug therapy is the major cause of immunocompromised status and occurrence of infections, which arise most commonly as a result of invasion by endogenous opportunists. Cytomegalovirus (CMV) remains one of the most important viral pathogen and studies suggest increased rejection episode associated with CMV infection. Polyomavirus-associated nephropathy (PVAN) remains an important cause of allograft dysfunction and graft loss after kidney transplantation. Tuberculosis (TB) is an important cause of morbidity in renal transplant recipients in developing world and the incidence of posttransplant tuberculosis in India has been reported to be highest in the world at 5.7–10% in various studies. The opportunistic infections with Nocardia and fungal infection like Aspergillosis, Mucormycosis, Candidiasis and others like Pneumocystis carinii in immunosuppressed patients were present with severe complications that are reviewed in this article. As a result of use of strong immunosuppressive drugs like tacrolimus, mycophenolate mofetyl (MMF) and antirejection therapy with antithymocyte globulins (ATG), these infections are now seen frequently, so they should always be included in differential diagnostic consideration.


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