Parainfluenza 3 Infections Early After Kidney or Simultaneous Pancreas-Kidney Transplantation

Area of Science:

• Transplantation immunology
• Virology
• Infectious diseases

Background:

• Parainfluenza virus (PIV) infections pose risks post-transplantation, particularly after hematopoietic stem cell or lung transplants.
• Data on PIV infections in kidney transplant recipients are limited.

Purpose of the Study:

• To describe an outbreak of Parainfluenza virus type 3 (PIV-3) in a kidney and simultaneous pancreas-kidney (SPK) transplant unit.
• To characterize PIV-3 infections in immunosuppressed transplant recipients.

Main Methods:

• Retrospective analysis of an outbreak in a transplant unit.
• Nasopharyngeal swabs analyzed by polymerase chain reaction (PCR) for respiratory viruses.
• Clinical data collection for patients undergoing kidney or SPK transplantation.

Main Results:

• PIV-3 infection was confirmed in 12 of 29 tested patients (including symptomatic and asymptomatic individuals).
• Most infections presented as mild upper respiratory symptoms; two patients developed lower respiratory tract issues requiring oxygen.
• PIV-3 was detected in 4/6 SPK patients and 8/39 kidney transplant patients (p=0.04).
• Prolonged viral shedding (11-16 days post-diagnosis) was observed.
• The outbreak lasted 24 days, ceasing after temporary ward closure.

Conclusions:

• PIV-3 infections in early post-kidney or SPK transplant periods are typically mild.
• Immunosuppressed transplant recipients are highly susceptible to PIV-3 infection.
• Prolonged viral shedding is a significant factor in transmission within transplant units.