Publication:

Clinical study on infections with special reference to tubercular infection in post-kidney transplant recipients from Western India

Background Infections remain a major cause of morbidity and mortality following kidney transplantation. The spectrum of infectious complications differs between developing and developed countries, with tuberculosis (TB) continuing to pose a significant challenge in endemic regions such as India. Data on post-transplant infections from western India are limited. Objectives were to evaluate the spectrum of infections, with special reference to tuberculosis, among kidney transplant recipients and assess their impact on graft and patient outcomes.

Methods This retrospective and prospective observational study was conducted at the department of nephrology, Goa Medical College, Goa, India. Sixty-two kidney transplant recipients transplanted between August 2018 and August 2025 were included. Demographic, transplant-related, infectious, tuberculosis-related, graft, and patient outcome data were analyzed. Risk factors for post-transplant tuberculosis were assessed using univariate analysis.

Results Of 62 recipients, 48 (77.4%) developed at least one infectious episode, accounting for 84 infectious events. Urinary tract infection was the most common infection (32.1%), followed by lower respiratory tract infection (26.2%) and tuberculosis (10.7%). Tuberculosis occurred in 9 recipients (14.5%), with extrapulmonary disease predominating (55.6%). Two-thirds of cases developed within two years of transplantation. Low socioeconomic status (OR 18.67, p=0.002) and chronic allograft nephropathy (OR 4.74, p=0.04) were significantly associated with post-transplant tuberculosis. Chronic graft dysfunction occurred in 30.6% and overall mortality was 29%. Mortality among tuberculosis patients was 88.9%.

Conclusions Infectious complications remain highly prevalent after kidney transplantation in western India. Tuberculosis continues to be associated with substantial graft dysfunction and mortality, highlighting the need for early diagnosis, vigilant surveillance, and prompt management.