Acute bacterial graft pyelonephritis is the most frequent type of sepis (bacterial pneumonia is the second most common source)
Obtain renal transplant imaging to evaluate for sources of infection (i.e. urinary tract obstruction, renal abscess, or urine leakage)
BK polyomavirus may reactivate and lead to nephritis, ureteral stenosis, or hemorrhagic cystitis
Pneumocystis pneumonia is the most common fungal infection in patients without prophylaxis and after prophylaxis discontinuation (adjunctive steroids for treatment is controversial)
Vascular access may be challenging. Avoid subclavian lines or femoral venous acess on the side of the graft
Cardiovascular disease is the leading cause of mortality (accounts for 40-50% of deaths after the first year following renal transplant)
References
Darmon M, Canet E, Ostermann M. Ten tips to manage renal transplant recipients. Intensive Care Med. 2019;45(3):380-383.
