Chickenpox infection after renal transplantation
Anupma Kaul1, Raj K Sharma1, Dharmendra Bhadhuria1
1Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Clinical Kidney Journal
|June 13, 2015
Summary
Chickenpox (varicella) infection in renal transplant recipients is rare but severe, causing graft dysfunction and high mortality. Pre-transplant vaccination is crucial for this immunocompromised group.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Chickenpox (varicella) is uncommon in immunocompromised individuals, especially renal transplant recipients.
- Data on adult renal transplant recipients with chickenpox is limited, but suggests a severe course with high morbidity and mortality.
Purpose of the Study:
- To evaluate the incidence, severity, and complications of varicella infection in renal transplant recipients.
- To assess outcomes over a 10-year follow-up period.
Main Methods:
- Retrospective analysis of live-related renal transplant recipients from June 2000 to June 2010.
- Evaluation of varicella infection incidence, clinical presentation, complications, treatment, and outcomes.
Main Results:
- 1.48% incidence of varicella infection in renal transplant recipients (median age 39).
- Graft dysfunction occurred in 5 patients (2 dialysis-dependent); no rejections noted. All patients required hospitalization.
- Complications included orchitis, pancreatitis, encephalitis, and gastritis. Mortality rate was 13.4% due to superinfections and CNS involvement.
Conclusions:
- Varicella infection can lead to severe outcomes, including significant morbidity and mortality, in immunocompromised renal transplant recipients.
- Highlights the critical importance of pre-transplant varicella vaccination in this high-risk population.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
827
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
827
01:16Kidney Transplant III: Nursing Management
587
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
587
01:28Kidney Transplant I: Introduction
739
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
739
01:27Cytomegalovirus Disease
42
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
42
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
514
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
514
01:29Acute Kidney Injury III: Clinical Manifestations
1.5K
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
1.5K