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[Pediatric kidney transplants and herpesvirus infections]
A Reyes Martín1, A Luque de Pablos, M J Canals Badía
1Hospital Provincial de Madrid.
Insights
This study tracked 27 children post-kidney transplant for viral infections like cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella-zoster virus (VZV). CMV infection was linked to allograft rejection and impaired renal function in transplant recipients.
Area of Science:
- Pediatric Nephrology
- Transplant Immunology
- Virology
Context:
- Post-renal transplant care requires monitoring for opportunistic viral infections.
- Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella-zoster virus (VZV) pose significant risks to pediatric transplant recipients.
- Understanding the incidence and impact of these viral infections is crucial for improving patient outcomes.
Purpose:
- To prospectively investigate the incidence and clinical significance of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella-zoster virus (VZV) infections in children following renal transplantation.
- To assess the relationship between viral infections and allograft rejection, renal function, and patient mortality.
Summary:
- Twenty-seven children undergoing renal transplantation were monitored for CMV, EBV, and VZV infections.
- Primary infections occurred in 27 patients (18 CMV, 1 EBV, 8 VZV), with 3 reinfections (2 CMV, 1 VZV).
- CMV infection was associated with allograft rejection (1 case), renal function impairment (7 cases), and one mortality. VZV reinfection was linked to one case of allograft rejection.
Impact:
- Highlights the significant morbidity associated with viral infections, particularly CMV, in pediatric renal transplant recipients.
- Emphasizes the need for vigilant surveillance and management strategies for CMV, EBV, and VZV infections post-transplant.
- Informs clinical practice regarding the prevention and treatment of viral complications to reduce allograft loss and improve survival rates.
Abstract:
Twenty seven children were followed up prospectively after renal transplant for evidence of infection and illness due to cytomegalovirus (CMV), Epstein-Barr virus (EBV) and varicella zoster virus (VZV). Virus shedding and serological status were tested at transplant day, biweekly for two months, monthly for six months and trimestrialy thereafter. Determinations were done by complement fixation test. CMV isolation was established by microscopic examination of urinary cultures. Primary infections were objetivated in 27 cases (18 CMV, 1 EBV, 8 VZV) and reinfection in 3 (2 CMV, 1 VZV). Irreversible allograft rejection related to infection was disclosed in 2 patients (1 primary CMV infection, 1 VZV reinfection). Renal function impairment occurred only with CMV (6 primary and 1 secondary infections). One patient died with CMV over infection.