ETIOLOGICAL SPECTRUM AND OUTCOME OF DIARRHOEA IN KIDNEY TRANSPLANT RECIPIENTS : SINGLE-CENTRE RESEARCH

Introduction:

Diarrhoea is one of the important causes of morbidity and graft dysfunction in kidney transplant recipients (KTRs). The etiological profile of diarrhea in India differs from that of developed nations due to different socio-economic conditions. This study was conducted to ascertain the etiology and clinical profile of posttransplant diarrhea in KTRs.

Methods:

This was a prospective observational cohort study of posttransplant diarrhea in KTRs. All the patients who underwent kidney transplant between January 2022 and June 2023 and had developed diarrhea within 12 months of the transplant were recruited. Demographic, clinical, and laboratory data, treatment administered, and outcomes were noted.

Results:

Between the recruitment period, 309 patients underwent transplants, of which 106 had diarrhea with a mean age of 39.74 years. Posttransplant infection was the main cause of diarrhea, identified in 55 (51.89%) patients, followed by immunosuppression (7), sprue (2), laxative (1), and drugs (1). When it came to infectious agents, Cryptosporidium (21 cases), Giardia (12 cases), Norovirus (5), CMV (3), Entamoeba histolytica (3), Rotavirus (3), Pseudomonas (3), Klebsiella (2), Tuberculosis (1), Astrovirus (1), EAEC (1), and Clostridium difficile (1) were the most common.
Approximately 69.09% of patients resolved diarrhea after receiving infection treatment; 27% had persistent diarrhea, whereas the remaining individuals resolved through the implementation of supportive care measures.
Acute graft dysfunction affected 77.25% of patients, and 72.64% showed graft recovery.

Conclusions:

In Approximately 69.09% diarrhoea resolved without any change in immunosuppressive therapy.

This study underscored the importance of thoroughly investigating posttransplant diarrhea prior to altering the immunosuppressive regimen.

Inappropriate reductions in immunosuppression can increase the risk of acute rejection and de novo donor-specific antibody formation.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.