Dengue in patients with kidney transplant: a systematic review.

Introduction: The incidence of dengue and its complications increases globally, mainly in areas where it is endemic; however, little literature evaluates outcomes in kidney transplant recipients (KTR). The present analysis aimed to determine the incidence, signs and symptoms, and allograft dysfunction in dengue-infected KTR.

Methods: Systematic review of the literature following PRISMA 2020 indications with studies included until November 24, 2023.

Results: Of 309 articles found, seven full-text studies were identified for analysis. 4337 KTRs with 214 dengue cases were evaluated. The incidence of dengue was 4.93%, varying between geographic regions. The average age was 41.50 years, and 61.21% were men. A mortality of 7.01% was reported. The symptoms were fever 83.18%, arthralgia 19.46%, myalgia 43.24% and headache 34.18%. The proportions of febrile dengue, with warning signs and severe dengue, were 63.55%, 23.83% and 11.68%, respectively. Transplant dysfunction and loss occurred in 63.08% and 4.67%, respectively.

Conclusions: Although the global distribution of dengue in KTR is unknown, there is a variable incidence between geographical areas and study times in which the KTR are evaluated. There is a high incidence of febrile symptomatology and transplant dysfunction consistent with global cohorts for non-KTR and KTR patients, respectively. Dysfunction is a prevalent event in KTRs with dengue infection, so correct screening should be done for donors and transplant candidates.