Kidney transplantation (KT) offers the greatest potential for survival and quality of life in patients with end-stage renal disease. Surgical site infection (SSI), however, is a frequent and significant complication in KT recipients. Data on this outcome remain limited, especially in Brazilian centers. This study aimed to identify the incidence, associated factors, and prognosis of SSI after KT. A non-concurrent cohort conducted between 2013 and 2020 included patients aged ≥15 years who underwent KT at a single Brazilian center. The primary outcome was SSI within 30 days post-KT. The cohort included 824 KT patients, of whom 46 (5.6%) developed SSI. The incidence of SSI showed an increasing trend over the period (p = 0.033). The main clinical presentations were superficial incisional (54.3%) and organ/space SSI (37%). Microbiological profile was dominated by Enterobacterales (51.4%), with a high proportion of ESBL-producing strains (66.6%). In multivariate analysis, BMI ≥ 25 kg/m² (OR 4.02; 95% CI 1.85–9.94; p = 0.001) and surgical complications (OR 2.17; 95% CI 1.49–3.70; p < 0.001) were independent predictors of SSI. Patients with SSI had longer hospital stays (mean 20.5 vs. 13 days; p < 0.001), with SSI-related lethality of 2.2%. SSI after KT was independently associated with elevated BMI and surgical complications. These findings suggest that patients with this profile may benefit from increased surveillance and optimized surgical and preventive measures, as well as early and careful clinical evaluation. Furthermore, based on the results presented, reducing obesity prior to transplantation appears to be beneficial in lowering SSI incidence rates.
Brandt et al. (Sun,) studied this question.