Infections are among the main postoperative complications after kidney transplant and directly impact graft and patient survival. The objective of this study was to analyze the incidence and main risk factors associated with infections in the first year after transplant. Integrative review based on observational studies and retrospective cohorts published between 2005 and 2022. Publications with epidemiologic and clinical data of kidney transplant recipients with a minimum follow-up of 12 months were included. The main variables analyzed were type of infection, time of occurrence (early, intermediate, and late), and risk factors such as deceased donor, cold ischemia time, and use of immunosuppressive agents. The incidence of infections in the first year ranged from 49% to 63% across the studies. Urinary tract infections (UTI) were the most prevalent, accounting for up to 51.5% of cases, followed by viral infections such as cytomegalovirus (CMV), herpes simplex, and BK virus. UTIs were more common in the first month post-transplant, whereas CMV predominated in the intermediate period (1 to 6 months). Significant risk factors included deceased donors, prolonged cold ischemia time, intensive use of immunosuppressants, and advanced recipient age. Recurrent infections were associated with reduced graft function and higher risk of hospitalization. Infections in the first year after kidney transplant are frequent, particularly UTIs and viral infections, and follow a predictable temporal pattern. The presence of modifiable risk factors, such as ischemia time and immunosuppressive regimen, underscores the importance of personalized prevention and monitoring strategies. Early interventions and appropriate surveillance protocols are essential to reduce morbidity, preserve graft function, and improve survival in transplant recipients.
Lameira et al. (Sun,) studied this question.
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