Incidence and Outcomes of Parasitic Infections in Renal Transplant Recipients: A 15-year Single-center Study
P Aravindhmozhi, V. S. Suprajaa, Raja Lakshmanan, Pranov Rengaswamy, Charankumar Swamikkannu, S Saravana Balaji, Karthik Rajan Udhayakumar, Dineshkumar Thanikachalam, Sakthirajan Ramanathan, Sheik Sulthan Alavudeen, M. Seenivasan, Jayalakshmi Seshadri, Balasubramaniyan Thoppalan, Gopalakrishnan NatarajanBackground:
Parasitic infections, though less common than bacterial or viral infections, are a significant yet under-recognized cause of morbidity in renal transplant recipients. Indian literature is largely limited to case reports or small series.
Methods:
We conducted a single-center retrospective observational study of all renal transplant recipients diagnosed with parasitic infections between January 2010 and January 2025. Demographic, transplant, and clinical data were retrieved. Outcomes assessed included graft dysfunction, hospitalization, and recovery of graft function. Statistical analysis compared single parasitic infection versus co-infection groups.
Results:
Among 895 renal transplants, 20 patients (2.2%) had experienced 24 parasitic infections. Gastrointestinal involvement was predominant (90%). Three patients (15%) had parasitic co-infection and one had recurrence. The mean age at transplant was 31 years, with male predominance (65%). During infection, the mean serum creatinine rose from 0.9 mg/dl to 1.7 mg/dl, with incomplete recovery in 30%. Graft dysfunction occurred in 55% and hospitalization in 65% including intensive care unit care in 10%. Two patients (10%) died, yielding a patient survival of 90% at follow-up. On comparative analysis, no statistically significant associations were found between co-infection and donor type, induction or maintenance immunosuppression, rejection history, calcineurin inhibitor toxicity, hypertension, or posttransplant diabetes mellitus.
Conclusion:
This study represents one of the largest Indian series on parasitic infections in renal transplant recipients. It highlights gastrointestinal predominance, frequent graft dysfunction, and high hospitalization despite favorable survival. No specific risk factors were significantly associated with co-infection suggesting multifactorial causation. Early diagnosis and timely therapy remain crucial to optimize graft and patient outcomes.