Dengue fever in renal transplant patients: a systematic review of literature

Abstract

BackgroundDengue fever in renal transplanted patients has not been studied well, and we review all the literature about episodes dengue fever in renal transplant patients.MethodsThe aim was to describe clinico-pathological characteristics, immunosuppressive protocols, need renal outcome and mortality. PubMed, LILACS, Google Scholar and Research Gate were searched for “Dengue” and “Renal/Kidney Transplantation” with no date limits. Hits were analyzed by two researchers separately.ResultsFever, myalgia, arthralgia and headache was significantly lower than normal population, while pleural effusions and ascites were observed more. Incidence of severe dengue is significantly higher among transplant patients in this review, as well as they had a significantly higher mortality (8.9% vs 3.7%, p = 0.031). Age, period after transplantation and immunosuppressive profile had no effect on disease severity, mortality or graft out come. Presence of new bleeding complications and ascites was associated with more severe disease (p < 0.001 and p = 0.005), death (p = 0.033) or graft loss (p = 0.035). Use of tacrolimus was associated with new bleeding complications (p = 0.027), and with ascites (p = 0.021), but not with thrombocytopenia. 25% of patients with primary disease fail to mount an IgG response by 15 weeks of the illness. 58.9% had graft dysfunction during illness. Postoperative transplanted patients were at risk of severe disease and unfavorable outcome.ConclusionsThe physical and laboratory findings in dengue fever in renal transplanted patients differ from the general population. Some degree of graft dysfunction is common during the illness, but only a minority develops graft failure.

Dengue fever in renal allograft recipients: Clinical course and outcome

“…The only available systematic review by Weerakody et al includes 10 records (inclusive of case reports) of dengue in transplant recipients . Of the 29 patients with clinical outcomes, fever, myalgia, and headache were common manifestations seen in over 90% of the patients; arthralgia was rare (25%); thrombocytopenia was common (88%); and transient graft dysfunction (38%) was similar to our case series.…”

Imported Arbovirus Infections in Spain, 2009–2018

“…According to published data, CHIKV in solid organ transplant recipients seems to have a benign course and favorable outcome (19,20), whereas data for DENV in these patients are less clear. Case descriptions report uncomplicated outcomes, whereas a recent literature review reported a significantly higher incidence of severe dengue and a higher mortality rate among transplant patients with dengue (21)(22)(23). A recent report of DENV, ZIKV, and CHIKV infections diagnosed in hematopoietic stem cell transplant recipients and oncohematologic patients found prolonged viremia in those with DENV and viruria in those with ZIKV; the most common complication was thrombocytopenia, but all patients survived without sequelae (24).…”

Yellow fever disease in a renal transplant recipient: Case report and literature review

“…Previous reports showed a lower frequency of classic symptoms and a higher incidence of severe disease and mortality among dengue‐infected solid organ transplant recipients, without infection‐related graft rejection . Little is known about the natural history of Zika virus infection in organ recipients, with some fatal cases reported .…”