Transplant Tourism And Malaria In Saudi Kidney Transplant Recipients: Case Reports And Literature Review

Malaria is an uncommon but potentially severe complication in solid organ transplant (SOT) recipients.Transmission may occur via donorderived infection, transfusion exposure, or de novo acquisition in endemic areas.Immunosuppression blunts cytokine-mediated febrile responses, often delaying diagnosis and permitting high-burden parasitemia.We report two kidney transplant recipients who developed Plasmodium falciparum and Plasmodium vivax malaria following overseas transplant procedures.These cases highlight diagnostic pitfalls related to afebrile presentation, clinical resemblance to rejection or graft-related complications, and the critical importance of epidemiological screening.Both patients responded favorably to intravenous artesunate followed by appropriate oral therapy.Our findings reinforce malaria as a key differential diagnosis in post-transplant recipients presenting with unexplained anemia, encephalopathy, cytopenias, or graft dysfunction, particularly in the setting of transplant tourism.