Characteristics and outcomes of dengue infection in kidney transplant recipients: an integrative review.

Dengue is an arbovirus infection caused by the dengue virus, common in tropical and subtropical areas. It is mainly transmitted by bites from infected Aedes aegypti and Ae. albopictus mosquitoes, but donor-derived cases have been reported. In kidney transplant recipients with dengue, immunosuppressive therapy can affect their immune response and disease presentation. This study analyzed the characteristics and outcomes of kidney transplant recipients diagnosed with dengue. An integrative review was conducted, including case reports, series, case-control, and cohort studies. The PubMed/Medline search in August 2025 used this syntax: ((kidney transplantation) OR (renal transplantation)) AND (dengue). The articles were selected by two reviewers, with a third resolving discrepancies. The database search found 72 articles. After removing duplicates, 71 were screened. Overall, 41 articles were excluded because they did not address the study subject. In total, 30 articles underwent full-text review; eight were excluded-seven lacked kidney transplant recipients with dengue and one had insufficient case details on infected cases. This review included 22 studies from dengue-endemic countries regarding infection occurring from days to years after transplant. Bleeding was more common in infections occurring early post-transplant, possibly linking early infection to severe symptoms. The main symptoms were fever, myalgia, and headache, similar to those in immunocompetent hosts. Thrombocytopenia was frequent, likely due to viral infection and immunosuppressive drugs that affect bone marrow function. No studies assessed the effect of dengue on anti-human leukocyte antigen antibodies or on graft rejection. Graft loss was 4%, and most patients recovered from the disease.