Post Kidney transplant infections
1. Nosocomial and surgery-related infections are the predominant infections that occur within the first month post transplantation.
2. Although the human polyomaviruses are highly seroprevalent in humans, they appear to cause clinical disease only in immunocompromised hosts.
3. The goal in treating BK-associated nephropathy is to eradicate the virus while maintaining kidney function and preventing acute or chronic rejection.
4. CMV-positive donor to CMV-negative recipient (CMV D+/R-) transplants are at greatest risk for severe “primary” infection during the first 3 months post transplantation. However, CMV D+/R+ group and not the D+/R- group has the worst graft and patient survival at 3 years. This could be secondary to increased vigilance in monitoring the CMV D+/- group.
5. Epstein-Barr virus can flourish in the setting of immunosuppression and is associated with the majority of posttransplant lymphoproliferative disorder.
6. Live vaccines are contraindicated post transplant.