Invasive Fungal Infections in Renal Transplant Recipients: A Single-Center Experience from South India
M Niranjan, Vishnukeerthana Kotha, Ankit Tiwari, Megha S Uppin, Kaushik Sridhara, Pallavi Uppal, Siddarth Herur, M Prasanna, Snigdha Bachalakuri, Vijaychander Bukka, Swarnalatha GuditiAbstract
Background:
Invasive fungal infections are serious complications in renal transplant recipients and are associated with significant morbidity, graft dysfunction, and mortality. Data from Indian transplant centers remains limited.
Objectives:
To describe the epidemiology, clinical spectrum, diagnostic approaches, management strategies, and short-term outcomes of fungal infections in renal transplant recipients at a tertiary care center in South India.
Materials and Methods:
This retrospective observational study included adult renal transplant recipients who developed microbiologically or radiologically confirmed fungal infections between January 2022 and December 2024 at a tertiary care center in Hyderabad, India. Demographic details, transplant characteristics, diagnostic modalities, antifungal therapy, surgical interventions, graft function, and 3-month outcomes were analyzed using descriptive statistics.
Results:
Twenty-two renal transplant recipients were included. The mean age was 38.4 years, with a male predominance (86.4%). Live-related transplantation was performed in 59.1% and deceased donor transplantation in 40.9%. The median time to infection was within the first year post-transplant. Gastrointestinal and pulmonary systems were the most commonly involved sites. Upper gastrointestinal endoscopy (36.4%) and bronchoalveolar lavage (27.3%) were the primary diagnostic tools. Fluconazole was the most frequently used antifungal agent (40.9%), while amphotericin B-based combination therapy was required in severe cases. Graft dysfunction occurred in 59.1% of patients at presentation. Surgical intervention was required in 27.3% of cases. Graft loss occurred in 4.5%, and 3-month mortality was 13.6%.
Conclusion:
Fungal infections in renal transplant recipients are associated with substantial morbidity, graft dysfunction, and need for surgical intervention. Early diagnosis and timely antifungal therapy are essential to improve outcomes in resource-constrained settings.