A retrospective study to describe the epidemiology and outcomes of opportunistic infections after abdominal organ transplantation

Background: Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplantation are derived prior to the era of contemporary immunosuppression and prophylaxis. These studies suggest that most OI occur within the first 6 months post transplant. Method: In this single-center, retrospective cohort study, we describe the epidemiology of OI in 359 consecutive abdominal organ transplant recipients, in the era of contemporary prophylaxis practices and alemtuzumab induction in kidney and simultaneous pancreas-kidney transplant recipients. Results: Ninety patients (25.1%) developed OI, with 53.3% of these occurring beyond 6 months. The most common OI were BK polyomavirus nephropathy (5.0%), cytomegalovirus (10.2%), varicella zoster virus (4.4%), and herpes simplex virus (1.1%), which typically occurred after discontinuation of antiviral prophylaxis, and Clostridium difficile infections (7.8%). Conclusion: OI had no impact on patient or graft survival at 12 months post transplant. In the era of contemporary immunosuppression and prophylaxis, a significant proportion of OI occur beyond 6 months. Additional strategies may be important to reduce the incidence of such late-onset infections.