Viral Infections after Kidney Transplantation: An Updated Review

Abstract

Infections are the major cause of morbidity and mortality in kidney transplant recipients. Careful pretransplant screening, immunization, and posttransplant prophylactic antimicrobials may all reduce the risk for posttransplant infections. Chronic immunosuppression, required to maintain allograft function post-organ transplant, predisposes transplant patients to a variety of viral infections. These can occur at every stage of post-transplantation. Some infections, however, such as cytomegalovirus (CMV), Epstein Barr virus (EBV), or BK virus (BKV), tend to occur within months after transplantation. CMV infections can be easily prevented by prophylaxis therapy, whereas EVB or BKV infections can be prevented by lowering immunosuppression. Some viral infections can result in posttransplant lymphoproliferative disorders (EBV), Kaposi sarcoma (human herpes simplex virus type 8), or skin and/or cervical cancers (papillomavirus). Other viral infections, such influenza viruses, are mostly acquired through environmental spread. These all can be easily detected at early stages, and can be efficiently treated.