2016 Volume 4 Issue 1 Pages 75-82
Despite the fact that graft and patient survival rates after kidney transplantation are improving, infectious disease is still the most common cause of death among recipients. Therefore, careful preoperative evaluation of both donor and recipient candidates for infectious diseases is highly important. Hepatitis B and C viruses, human immunodeficiency virus (HIV), human T-cell leukemia virus type 1 (HTLV-1), cytomegalovirus (CMV), and others can be transmitted from an infected donor to a recipient naïve for these viruses. Such transmission can be avoided with adequate screening of donor candidates. In addition, some recipients are silently infected by these viruses, tuberculosis, or Pneumocystis jirovecii preoperatively. Post-transplant reactivation of such latent pathogens under immunosuppression in infected recipients should be carefully monitored or treated prophylactically according to the findings on preoperative evaluation. Candidates for kidney transplants who are negative for anti-measles, mumps, chicken pox, and rubella antibodies should be immunized with live attenuated vaccines before kidney transplantation. Postoperatively, under immunosuppressive conditions, inactivated vaccines including seasonal flu, hepatitis B, and Haemophilus influenzae type B (Hib) vaccines can be employed. Recipient transplant coordinators must be familiar with evaluation, monitoring, and treatment of infectious diseases in kidney transplant recipients. This review article outlines the general and essential knowledge about infectious diseases in kidney transplantation.
