Infections after renal transplants are the main worry that kidney recipients have. As we age, our natural immunity goes down. A kidney transplant further lowers immunity. Especially in a tropical country like India, infections can sometimes prove fatal to older adults who have undergone a kidney transplantation procedure.
India is second in the world in kidney transplant operations with a success rate of nearly 100%. People from all over the world come to India for kidney transplantation. On average, around 3,000 renal transplants happen annually in India.
However, infections are a huge threat always hovering over the kidney recipients. Here is a list of infections that can affect a patient of renal transplants in the order in which they will appear:
- Urinary Tract Infection (UTI): UTIs are common within the first-month post-transplantation. They account for most of the bacteremias in the first month. In some cases, multiple or persistent UTIs can cause end-stage renal failure. Quick and correct diagnosis and treatment may help in reducing the occurrence or intensity of UTIs.
- Wound infections: As the immunity of the body is low, taking immunosuppressant medication after a kidney transplant can make you very vulnerable to outside infections. If your wound is not meticulously cleaned in aseptic conditions, there is a strong possibility of the wound getting infected due to the entry of unwanted fungi and bacteria. Make sure the wound is kept dry at all times and do not touch it without washing your hands properly first.
- Viral infections: Herpes viruses type 1 and 2 are very likely to attack your immunocompromised body. The occurrence of Herpes zoster (shingles) and genital herpes is very common.
- Pneumocystis carinii Pneumonia (PCP): PCP occurs in the second to sixth month period. It is a life-threatening condition wherein the lungs are affected. It affects people with weakened immune systems. A kidney recipient on immunosuppressant medication is an ideal target for the Pneumocystis jirovecii fungus.
- Mycobacterial Infections: Mycobacterial infections are one of the major causes of morbidity and mortality. People with post-transplantation TB are more prone to contracting mycobacterial infections. TB is a very common threat in immunocompromised kidney recipients. However, the treatment for mycobacterial infections is quite complicated as the patient may be resistant to the drugs used to cure them. This becomes even more complex in an immunocompromised older adult.
- Hepatitis B and C Virus Infections: Chronic liver infections affect 10% of the patients. These lead to renal failure, liver cancer, decreased immunity and altered metabolism of medication. Most patients with severe liver cell failure have hepatitis viral infections. Blood transfusions before transplantation and regular screening can reduce the number of occurrences of liver infections due to hepatitis B and C viruses.
Infection is a major hazard of kidney transplantation in India. In older adults with low immunity, immunosuppressant medication might wreak havoc. By continuously monitoring your body for any symptoms and attending regular follow-ups with your doctor, you can overcome these hurdles and live a satisfactory life after transplant.
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