Oral manifestations of allograft recipients immediately before and after kidney transplantation

Abstract

Objective: To identify the oral lesions of individuals with kidney disease immediately before and shortly after kidney transplantation, taking into account the immunosuppressive regimen, antiviral prophylaxis and type of transplantation.

Methods: A prospective observational cohort study was carried from January 2017 to January 2018. Eighty individuals aged 18 years or older who were admitted for kidney transplantation were eligible to participate. Clinical data regarding medical history, immunosuppressive therapy, antiviral prophylaxis, laboratorial data and oral examination were performed by the same trained researcher, in three different moments: 24 hours before transplantation (1st time point), 15–20 days (2nd time point) and 45–60 days (3rd time point) after transplantation.

Results: In the first, second and third time points, it was found that 3.7% (3/80), 23.7% (18/76) and 25.7% (19/74) of the participants showed oral soft tissue lesions. Ulcers and candidiasis were the most frequent oral lesions, and they were associated with the use of everolimus (p = .005) and azathioprine (p = .034), respectively. Less patients reported xerostomia after transplantation than before (p < .001).

Conclusions: Oral lesions are common in the short term after renal transplantation and are particularly related to both toxicities of immunosuppressive drugs and immunosuppression.

Keywords:

• Kidney transplantation
• oral lesions
• immunosuppressive agents
• candidiasis
• stomatitis

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards set by institutional and/or national research committees and with the 1964 Helsinki declaration, including its later amendments or comparable ethical Standards. This study was approved by the Research Ethics Committee of the University of São Paulo School of Dentistry according to protocol number 1.824.857.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This study was supported by São Paulo Research Foundation (FAPESP) for the current financial support according to protocol number 2017/07778-8.