Graft Arteritis Due to Candida Spp. After Kidney Transplant: A Systematic Review of Individual Cases

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Abstract
Background: Graft arteritis due to Candida species (GAC) is a rare but life-threatening complication in kidney transplant recipients. This systematic review examines its clinical profile and outcomes. Methods: A PRISMA-compliant systematic review was conducted. Cases of GAC in kidney transplant recipients were identified and analyzed for clinical characteristics and outcomes. Results: Sixty-one patients from 31 studies were included. Median time to infection was 30 days (IQR: 12–60 days) post-transplant. Common symptoms included fever (41.5%) and abdominal pain (33.9%). Aneurysmal rupture occurred in 49.1%, often linked to early presentation. Surgical intervention, mainly external iliac artery ligation, was required in most cases. Mortality was 22.9% and was associated with candidemia and a significantly shorter interval between transplantation and clinical presentation. Conclusions: GAC typically occurs early after kidney transplantation, with high rates of aneurysmal rupture and mortality.

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