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Updated: Feb 12, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Infectious disease risks in pediatric renal transplantation
Felicia A Scaggs Huang1, Lara Danziger-Isakov2
1Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, 333 Burnet Avenue/MLC 7017, Cincinnati, OH, 45229, USA. Felicia.ScaggsHuang@cchmc.org.
Insights
Pediatric kidney transplant recipients face significant infection risks. Understanding infection timing and causes is crucial for timely diagnosis and treatment in these vulnerable patients.
Area of Science:
- Nephrology
- Pediatric Infectious Diseases
- Transplantation Immunology
Background:
- Renal transplantation is a critical treatment for pediatric end-stage renal disease (ESRD), with over 10,000 procedures and >80% 10-year survival in the USA.
- Infections remain a major source of morbidity in pediatric kidney transplant recipients, necessitating proactive management.
- Screening donors and recipients for infectious risks is essential to mitigate post-transplant complications.
Purpose of the Study:
- To outline common infections in pediatric kidney transplant recipients.
- To detail clinical manifestations, risk factors, diagnostic methods, and treatment strategies for these infections.
- To provide a framework for timely and effective infectious evaluations in this population.
Main Methods:
- Review of common infections based on post-transplant timing (early, intermediate, late).
- Analysis of pathogen types (bacterial, fungal, viral) and sources (donor-derived, nosocomial, community-acquired).
- Discussion of diagnostic techniques and therapeutic interventions.
Main Results:
- Early infections (<30 days) are often bacterial or fungal, linked to donor factors or hospital-acquired pathogens.
- Intermediate infections (31-180 days) commonly involve reactivation of latent viruses like Epstein-Barr virus (EBV) and cytomegalovirus (CMV) from donor organs.
- Late infections (>180 days) can stem from latent pathogens or new community-acquired infections.
Conclusions:
- The timing of infections post-pediatric kidney transplant is predictable, aiding in diagnosis and management.
- A nuanced approach is required to diagnose and treat infections in pediatric transplant patients effectively.
- Comprehensive understanding of infection patterns is vital for improving outcomes in pediatric renal transplantation.
Abstract:
Renal transplantation is a vital treatment option in children with ESRD with more than 10,000 pediatric kidney transplants and survival rates of greater than 80% at 10 years post-transplant in the USA alone. Despite these advances, infection remains a significant cause of morbidity in pediatric recipients. Screening potential organ donors and recipients is imperative to identify and mitigate infectious risks in the transplant patient. Despite the unique risks of each patient, the timing of many infections post-transplant is predictable. In early post-transplant infections (within 30 days), bacterial and fungal pathogens predominate with donor-derived events and nosocomial infections. In the intermediate period (31-180 days after transplant), latent infections from donor organs, such as EBV and CMV, develop. Late infections occurring > 180 days after the transplant can be due to latent pathogens or community-acquired organisms. Approaching an infectious evaluation in a pediatric kidney recipient requires finesse to diagnose and treat this vulnerable population in a timely manner. The following article highlights the most relevant and common infections including clinical manifestations, risk factors, diagnostic techniques, and treatment options.
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