Background and Aims: In some cases the KG’s storage solution turns out to be contaminated. This asymptomatic donor’s bacteremia can threat to recipient’s health and life, because of leading to various infectious complications. Moreover, primary graft infection is detected several days after surgery. The aim: to explore options for the clinical course and outcomes after primary-infected kidney transplantation.

Methods: we analyzed 1633 KTx. 72 cases of primary-infected renal allograft (PIRAG) transplantation were identified. All PIRAG’s recipients were initially prescribed immunosuppressive therapy (IST) and antibacterial prophylaxis with 3d gen of cephalosporins. The bacteriological research results were obtained on the 3-7 day after KTx. Having a positive result, the therapy was immediately adjusted according to the individual sensitivity of infection to antibiotics.

Results: In 47.2% cases, the Gram+ or - flora had been detected. Mixed infection - in 4.2% cases. Yeast fungi - in 1.4% cases. There were no any infectious complications in 72.2% of PIRAG cases. In 16.7% the development of local and/or generalized purulent-septic complications with the development of sepsis had been noted immediately (on 2-5 days after KTx). In such cases, emergency nephrotransplantectomy, revision, sanitation and drainage of infected areas were performed. Antibiotic therapy was prescribed, IST was canceled, and intravenous administration of human immunoglobulin was used. In cases of arrosive bleeding from the vessel’s anastomoses we performed the recipient’s external iliac artery and vein resection with simultaneous cross-iliac-femoral shunting. In 11.1% delayed complications with satisfactory graft’s function had been manifested.

Conclusion: PIRAG is an undoubted factor of septic complication’s development in kidney recipients. While PIRAG detected, the immediate antibacterial therapy maximization is necessary, with its correction according to microflora’s sensitivity to antibiotics.