Epidemiology and outcomes of dengue in kidney transplant recipients: A 20‐year retrospective analysis and comparative literature review

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 NS1 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 m2 (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.