Chicken pox after pediatric liver transplantation

Area of Science:

• Pediatric Gastroenterology and Hepatology
• Infectious Diseases
• Transplantation Immunology

Background:

• Previous reports indicate serious complications from chickenpox (CP) post-pediatric liver transplantation (PLT), often due to visceral dissemination.
• Understanding the incidence, risk factors, and outcomes of CP in this vulnerable population is crucial for patient management.

Purpose of the Study:

• To determine the incidence of chickenpox (CP) infections in pediatric liver transplant (PLT) recipients.
• To identify potential risk factors associated with CP development post-PLT.
• To evaluate the outcomes and complications following CP in PLT patients.

Main Methods:

• A case-control study design was employed, analyzing data from pediatric transplant recipients diagnosed with CP between September 1993 and April 2004.
• Cases of CP were compared with age-, gender-, and transplant year-matched controls.
• Data on potential pre-infection risk factors and post-infection adverse outcomes were collected and analyzed.

Main Results:

• Chickenpox (CP) occurred in 6.2% of pediatric liver transplant (PLT) recipients at a median of 1.8 years post-transplant.
• All CP infections were cutaneous, with no evidence of visceral dissemination.
• Patients who developed CP were significantly more likely to experience non-CP infections within one year post-infection (HR=12.6, P<0.001).

Conclusions:

• Chickenpox (CP) is relatively uncommon after pediatric liver transplantation (PLT) and typically presents with cutaneous manifestations, rarely involving organ dissemination.
• No specific pre-transplant risk factors were identified for developing CP.
• Close monitoring for late-onset bacterial infections is warranted in PLT recipients following CP.