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Volume 15
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10.3390/pathogens15040390
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Article

Kidney Transplant Recipients: Viral Infections and Malignancies

by
Costin Damian
1,
Adrian Constantin Covic
1,2,
Ramona Gabriela Ursu
1,3,*,
Aida Corina Badescu
1,4,
Simona Mihaela Hogas
1,2,
Andreea Simona Covic
1,2,
Mihai Isache
2,
Silvia Gabriela Ionescu
1,
Corneliu Morosanu
1,2,
Stefania Brindusa Copacianu
5 and
Luminita-Smaranda Iancu
1,6
1
Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iași, Romania
2
Nephrology Clinic, Dialysis and Renal Transplant Center, C. I. Parhon University Hospital, 700503 Iasi, Romania
3
“Cuza-Vodă” Clinical Hospital of Obstetrics and Gynecology, 700038 Iasi, Romania
4
Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania
5
Microbiology Laboratory, Regional Institute of Oncology, 700483 Iasi, Romania
6
National Institute of Public Health, Iasi Regional Center for Public Health, 700465 Iasi, Romania
*
Author to whom correspondence should be addressed.
Pathogens 2026, 15(4), 390; https://doi.org/10.3390/pathogens15040390
Submission received: 14 March 2026 / Revised: 31 March 2026 / Accepted: 3 April 2026 / Published: 5 April 2026
(This article belongs to the Special Issue Oncogenic Viruses: Advances in Molecular Diagnosis, Prevention Strategies and Therapy—2nd Edition)
Versions Notes

Abstract

Kidney transplant recipients (KTRs) remain vulnerable to infectious complications and malignancies due to chronic immunosuppression, both of which may contribute to allograft dysfunction and adverse clinical outcomes. This study aimed to evaluate the prevalence of viral infections and post-transplant malignancies among hospitalized KTRs and to identify factors associated with acute kidney injury (AKI) and chronic graft dysfunction. We conducted a prospective observational study including 215 adult KTRs admitted to a tertiary transplant center over a one-year period. Clinical data, malignancy history, and viral detection for BK polyomavirus (BKV), cytomegalovirus (CMV), Epstein–Barr virus (EBV), and parvovirus B19 were analyzed. AKI occurred in 65.6% of patients, while chronic graft dysfunction was present in 21.4%. Viral positivity was detected in 16.7% of the cohort, most frequently BKV and CMV. Infectious etiologies represented the most common cause of AKI. Viral positivity was significantly associated with infectious mechanisms of AKI and was independently associated with AKI in multivariable analysis (adjusted OR 3.01, p = 0.02). In a separate multivariable model, malignancy history (aOR 9.30), viral positivity (aOR 3.33), and concurrent AKI (aOR 3.42) were independently associated with chronic graft dysfunction. These findings suggest that viral reactivation and malignancy history cluster with clinical states of increased graft vulnerability in hospitalized KTRs. Integrated evaluation of infectious, immunologic, and clinical factors may improve risk stratification and management of transplant recipients presenting with acute illness.
Keywords: kidney transplant; acute kidney injury; BK polyomavirus; cytomegalovirus; Epstein-Barr virus; parvovirus B19; post-transplant malignancy kidney transplant; acute kidney injury; BK polyomavirus; cytomegalovirus; Epstein-Barr virus; parvovirus B19; post-transplant malignancy

Share and Cite

MDPI and ACS Style

Damian, C.; Covic, A.C.; Ursu, R.G.; Badescu, A.C.; Hogas, S.M.; Covic, A.S.; Isache, M.; Ionescu, S.G.; Morosanu, C.; Copacianu, S.B.; et al. Kidney Transplant Recipients: Viral Infections and Malignancies. Pathogens 2026, 15, 390. https://doi.org/10.3390/pathogens15040390

AMA Style

Damian C, Covic AC, Ursu RG, Badescu AC, Hogas SM, Covic AS, Isache M, Ionescu SG, Morosanu C, Copacianu SB, et al. Kidney Transplant Recipients: Viral Infections and Malignancies. Pathogens. 2026; 15(4):390. https://doi.org/10.3390/pathogens15040390

Chicago/Turabian Style

Damian, Costin, Adrian Constantin Covic, Ramona Gabriela Ursu, Aida Corina Badescu, Simona Mihaela Hogas, Andreea Simona Covic, Mihai Isache, Silvia Gabriela Ionescu, Corneliu Morosanu, Stefania Brindusa Copacianu, and et al. 2026. "Kidney Transplant Recipients: Viral Infections and Malignancies" Pathogens 15, no. 4: 390. https://doi.org/10.3390/pathogens15040390

APA Style

Damian, C., Covic, A. C., Ursu, R. G., Badescu, A. C., Hogas, S. M., Covic, A. S., Isache, M., Ionescu, S. G., Morosanu, C., Copacianu, S. B., & Iancu, L.-S. (2026). Kidney Transplant Recipients: Viral Infections and Malignancies. Pathogens, 15(4), 390. https://doi.org/10.3390/pathogens15040390

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