Viral Infections After Kidney Transplantation in a Cohort of Children: A Retrospective Single-Center Study

Transplant Proc. 2019 Mar;51(2):522-525. doi: 10.1016/j.transproceed.2019.01.010. Epub 2019 Jan 4.

Abstract

Background: Viral infections are known to be common complications after kidney transplant (KTx), causing significant numbers of mortality and morbidity.

Objectives: We aimed to highlight the pattern of viral infections after KTx in children and its impact on allograft function.

Methods: We included children who underwent KTx between 2012 and 2017. Baseline demographics, immunosuppressive agents, episodes of viral infections with cytomegalovirus (CMV), BK virus, and Epstein-Barr virus (EBV), and serum creatinine were collected. All children received induction agent followed by maintenance immunosuppression. Oral valganciclovir was given to all high-risk patients for CMV for 180 days as prophylaxis. CMV and EBV polymerase chain reactions were monitored every 2 weeks initially until the ninth month, then monthly until the end of the second year, and then every 3 months. Urine BKV polymerase chain reactions were monitored monthly in the first year and then every 3 months.

Results: A total of 18 children received transplants. There was 1 episode of CMV infection (5.6%), 2 episodes (11.1%) of isolated BK viruria (1 of the 2 with an episode of BK viremia [5.6%] with no associated BK nephropathy [0%]), and no episodes of EBV or lymphoproliferative disease (0%). Allograft functions continued to be stable with mean serum creatinine of 52.2 μmol/L during the study period with 2 episodes (11.1%) of acute cellular rejection and 1 episode (5.6%) of early antibody-mediated rejection.

Conclusion: Prolonged prophylaxis and strict viral monitoring protocol can be effective ways of controlling viral infections after KTx.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use
  • Child
  • Female
  • Graft Rejection
  • Humans
  • Immunocompromised Host*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation / adverse effects*
  • Male
  • Retrospective Studies
  • Virus Diseases / epidemiology
  • Virus Diseases / immunology*
  • Virus Diseases / prevention & control

Substances

  • Antiviral Agents
  • Immunosuppressive Agents