Infections and Prophylaxis Following Kidney Transplantation
Özet
Although kidney transplantation is one of the most effective treatment options for end-stage renal disease, infections in the post transplant period are among the primary complications that determine patient and graft outcomes. The incidence and spectrum of these infections vary depending on surgical complications, allograft function, the intensity of the immunosuppressive regimen used, and prophylactic measures. In the early period, surgical site infections, catheter and catheter related infections, and hospital acquired bacterial infections are predominant, while opportunistic pathogens such as cytomegalovirus (CMV), BK polyomavirus, and Pneumocystis jirovecii become more prominent within the first 6 months. In the late phase, community-acquired infections predominate; however, the risk of opportunistic infections persists in patients receiving intensive or repeated immunosuppression. Urinary tract infections are the most common group of infections in kidney transplant recipients and are particularly associated with graft dysfunction, bacteremia, and hospitalization in the early phase. Although fungal infections are less common, they require early diagnosis and appropriate antifungal treatment due to their high mortality rate. Prophylactic and preemptive strategies play a critical role in the management of these infections, which directly impact both patient and graft survival. In this section, post-kidney transplant infections are addressed within a time-based framework; their clinical characteristics, diagnostic approach, treatment principles, and current prophylaxis strategies are summarized.
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