For patients with uremia, being able to receive a kidney transplant is the best form of treatment. Kidney transplantation can maximize the quality of life of patients and enable them to restore their social functions. For the transplantation surgery, the most important concerns of kidney patients are the good or bad match, the success of the surgery and the recovery of kidney function. Perhaps when you have experienced a successful surgery, passed the dangerous period of surgery, avoided rejection, and obtained good kidney function, you may be complacent about all this and even start to look forward to a better life, marrying a rich woman, becoming a CEO, and walking on the road of prosperity, please be vigilant to defend your home and prevent unpleasant or even catastrophic post-operative infections. The success and popularity of kidney transplantation and immunosuppression are inseparable, at least so far for kidney transplant recipients to receive high doses of immune induction therapy and hormone shock therapy early after surgery and long-term postoperative maintenance doses of immunosuppression is the best choice to prevent rejection and maintain the long-term survival of the transplanted kidney. As shown in the figure, the development of immunosuppression has led to a reduction in the incidence of rejection and an increase in the survival rate of the transplanted kidney. However, immunosuppressants, as the name implies, act on the immune system, and these drugs work around the various signaling nodes of the human immune system to combat rejection. But the suppression of the immune system brings not only a reduction in rejection, but also an increase in the incidence of infection. In fact, infection after kidney transplantation has always been a problem and a challenge for transplant surgeons. How to achieve a delicate balance between infection and rejection is an important consideration for transplant surgeons. The rules and characteristics of post-transplantation infections have been gradually understood after some painstaking exploration. The characteristics of infection at different stages after transplantation: The characteristics of infection after transplantation change with the time of transplantation. It can be roughly divided into three time periods: early post-transplantation (within 1 month after kidney transplantation), mid-transplantation (1-6 months after kidney transplantation), and post-transplantation maintenance (6 months after kidney transplantation). Early post-transplant infections Infections are usually associated with pre-transplant physical status or surgical complications. Bacteria and fungi are the most common pathogens in the 30 days after transplantation. >50% of bacterial infections occur in the early post-transplant period. Superficial and deep surgical site infections are the most common infectious complications during this period. Bacterial/fungal infections of donor origin are prone to occur during this period; mid-transplantation is the most typical time for the onset of reactivation of infection from potential risk factors in the donor organ, blood products, and recipient. This is also the time when classical opportunistic infections appear. In the absence of prophylaxis, CMV infections peak, and in the same absence of prophylaxis, EBV-associated PTLD, PCP, and fungal infections are common; Characteristics of post-transplant maintenance infections 6 months post-transplant, as immunosuppression is tapered and graft function is restored, the patient’s immunity gradually recovers and the risk of infection decreases, but the risk of long-term chronic infection is always present. Infections at this stage are predominantly community acquired infections, then the types of infections are more diverse for example fungal infections such as Mycobacterium tuberculosis and Cryptococcus become common causes of infections in the maintenance period after renal transplantation. The symptoms of infection in the renal transplant population are characteristic: and unlike infections in the general population, the clinical symptoms of infection in the renal transplant population are different from those in the general population due to suppressed immunity. Specifically, for patients in the early post-transplant period, the chance of infection increases due to the use of large amounts of immunosuppressants, while the use of hormones makes the local redness, swelling and pain not obvious, and wound healing is often difficult. For patients in the middle stage of post-transplantation, the immunity of the body is the lowest at this stage and is prone to serious and fatal infections, which are rare but the most serious life threatening pathogens. For example, cytomegalovirus infection (CMV), CMV in the vast majority of us have been infected at one time or another, but thanks to the normal immune system, people develop antibodies to CMV, so normally we do not need to have any fear of CMV. However, in patients after kidney transplantation, due to the lack of resistance, CMV, a typical opportunist, can take advantage of this stage to multiply and invade all systems of the body, most commonly developing CMV pneumonia, which affects the human respiratory system and can lead to death in severe cases. Similar infections include Pneumocystis carinii pneumonia (PCP), microviruses, and others. However, the clinical symptoms of this stage of infection are not typical at the earliest stage, mainly malaise, generalized pain and hypothermia as the early symptoms, which are easily ignored, but once they appear, the progress is very rapid, and some of them can develop severe hypoxemia in just one week, even requiring ventilator-assisted breathing, and the consequences are very serious and the treatment costs are huge. Therefore, I summarize the characteristics of this stage of infection: insidious symptoms, rapid progression, and serious consequences! What is the end of the long and slow road? It is always a relief to enter the maintenance phase after kidney transplantation! After entering the maintenance phase of kidney transplantation, the patient’s immune system gradually recovers, so you can relax a little about life-threatening infections such as CMV pneumonia and PCP! Gradually during the maintenance period you kidney patients are gradually reintegrated into society and start their own work and study life! But still do not let down your guard, because since the fact that there are long-term immunosuppressive drugs exist, the weak resistance still exists. In this stage is longer, so and long-term resistance weakness of the infection will appear, such as the old human friends Mycobacterium tuberculosis, Cryptococcus, BK virus, etc.. The clinical manifestations of the infection at this stage are still atypical, and even the imaging manifestations present less characteristic in the early stage, while hypothermia and wasting are the more common clinical features when the infection appears. For this stage of infection is not easy to clearly diagnose, the treatment course is long, so in your kidney friends if you appear similar situation must not let down your guard oh, because the symptoms early not violent, easy to let people have the idea of boiling a boil, in fact, do not know that this is the process of warm water boiling baby! Frozen three feet is not a day of cold, cold ice three feet is not a day can be solved! Told so much, the intention is not to make your kidney friends tremble, the above is about raising awareness of the chapter, we have the following to defend the motherland it! After all, we have a trick to defuse!