*Purpose: Post-transplant infection is a frequent and devastating complication after kidney transplantation (KT). Since the characteristics of post-transplant infection have changed over time after KT and are affected by various factors, studies on the latest trends of post-transplant infection are constantly needed. In this study, we investigated the current epidemiology, risk factors, and clinical impact of early post-transplant infection, defined as infection occurring within 6 months after KT, using a nation-wide cohort.

*Methods: This study was based on the Korean Organ Transplantation Registry (KOTRY) database. All of the 3,738 kidney recipients who registered in the KOTRY database between April 2014 and December 2017 were enrolled. The incidence, causative pathogens, and sites of overall early post-transplant infection were observed. We then, divided the recipients into two groups according to the presence or absence of early post-transplant infection to determine the risk factors for development of the infection. The effects of early post-transplant infection on clinical outcomes including cardiac events, rejection, graft loss, and all-cause mortality were also analyzed.

*Results: Among 3,738 kidney recipients, 670 (17.9 %) experienced at least one occasion of infection requiring hospitalization during the first 6months after KT. The most common causative pathogen was bacteria and the most frequent site of infection was urinary tract. Older age and female gender of recipient, use of deceased donor grafts, older donor, presence of donor specific antibody, and use of induction immunosuppression were independently associated with development of the early post-transplant infection. Recipients who experienced the early post-transplant infection had a higher risk of the development of cardiac events, rejection, graft loss, and all-cause mortality when compared to recipients who did not experience the infection.

*Conclusions: Our study showed the current trends, risk factors, and clinical impact of the early post-transplant infection after KT in Korea. Considering the poor consequence of early post-transplant infection, careful screening and monitoring of high risk kidney recipients are required.

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