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Epidemiology and outcomes of dengue in kidney transplant recipients: A 20‐year retrospective analysis and comparative literature review
Author(s) -
Pinsai Subencha,
Kiertiburanakul Sasisopin,
Watcharananan Siriorn P.,
Kantachuvessiri Surasak,
Boongird Sarinya,
Bruminhent Jackrapong
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13458
Subject(s) - medicine , dengue fever , interquartile range , epidemiology , retrospective cohort study , dengue virus , pediatrics , surgery , immunology
Background Kidney transplant ( KT ) recipients in dengue‐endemic areas are at risk of exposure. We investigated the epidemiology and outcomes from dengue in KT recipients at our transplant center and conducted a literature review. Materials and methods We conducted a 20‐year retrospective study of KT recipients who were diagnosed with laboratory‐confirmed dengue from January 1997 to September 2017 according to the 2009 World Health Organization ( WHO ) classification. We analyzed clinical characteristics and treatment outcomes. Results There were 13 (0.7%) dengue cases among 1917 KT recipients with a median age of 39 years (interquartile ranges [ IQR ], 22‐46); 54% were males. Cases occurred with a median onset of 24 months ( IQR , 6‐122) after KT . Dengue was diagnosed via dengue NS 1 antigen (85%), IgM antibodies (38.5%), or RT ‐ PCR (15.4%). Patients were classified as having dengue without warning sign (30.8%), with warning sign (53.8%), or severe dengue (15.4%). All patients resolved without complications, except one had hemophagocytic lymphohistiocytosis. Ten (76.9%) patients experienced eGFR reduction with a median of 13.7 mL/min/1.73 m 2 ( IQR , 8.3‐20.5); eight (80%) had a full allograft function recovery. Conclusions Dengue in KT recipients in endemic areas is uncommon. Although a transient decline in allograft function can occur, the overall clinical and allograft outcomes seem to be favorable.