Kidney Week

Abstract: SA-PO1122

Clinical Profile and Outcome of Norovirus Infection in Kidney Transplant Recipients in India

Session Information

• Transplantation: Clinical - Infectious Diseases
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Bagchi, Soumita, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Soumita Bagchi, MD

• Brijwal, Megha, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Megha Brijwal, MD, MBBS

• Choudhary, Aashish, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Aashish Choudhary, MD, MBBS

• Subbiah, Arunkumar, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Arunkumar Subbiah, MD, MBBS

• Mahajan, Sandeep, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Sandeep Mahajan, MD

• Bhowmik, Dipankar M., All India Institute of Medical Sciences New Delhi, New Delhi, DL, India

Dipankar M. Bhowmik, MD

Background

Norovirus(NoV) infection is an important complication after kidney transplantation. There is a dearth of data about the epidemiology and outcome of NoV diarrhoea in kidney transplant recipients in the Indian subcontinent.

Methods

In this retrospective cohort study, all kidney transplant recipients who presented with diarrhoea and were diagnosed with NoV infection between 2019-2023 at our centre were included and their clinical characteristics, treatment and outcomes were analysed.

Results

This study included 54 patients with NoV diarrhoea after transplantation, 7.4% with GI and 92.6% with GII. The median age was 33 (IQR 26,41)years, and 74.1% were male. 29.6% had chronic NoV infection. At presentation, the median serum creatinine was 1.8(IQR 1.2-2.5) mg/dl and 44.4% had acute kidney injury (AKI).
NoV gastroenteritis developed at a median of 4.6(IQR 2.8-7.6) years after transplantation with 6 patients presenting within the 1^st year after transplantation, 23 between 2-5 years, 19 within 5-10 years and 6 more than 10 years after transplantation. At last follow-up, serum creatinine remained 1.8(IQR 1.2,3.3)mg/dl; 16.7% had graft failure, and 2 died from other infectious complications. Key management strategies included reducing MMF dose in 50% of patients, switching to Azathioprine in 18.5%, and treating with Nitazoxanide in 74.1%. Multivariable logistic regression analysis revealed that serum creatinine at initial clinical presentation was significantly associated with graft failure (OR-3.56 95% CI: 1.51, 13.11, p=0.015).

Conclusion

NoV gastroenteritis can present any time after kidney transplantation. It is associated with high incidence of AKI and sustained decline in graft function.