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Updated: Jul 2, 2025

Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
Published on: November 10, 2023
Impact of Respiratory Viral Infections in Transplant Recipients
Hannah Bahakel1, Alpana Waghmare2, Rebecca Pellet Madan3
1Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Respiratory viral infections (RVIs) pose significant risks to pediatric transplant recipients, increasing morbidity and mortality. Understanding RVI epidemiology and outcomes is crucial for developing effective prevention and treatment strategies.
Area of Science:
- Pediatric Hematology/Oncology
- Infectious Diseases
- Transplant Surgery
Background:
- Respiratory viral infections (RVIs) are a major cause of illness and death in children who have received hematopoietic stem cell transplants (HCT) or solid organ transplants (SOT).
- These infections can lead to serious complications such as bacterial/fungal pneumonia, chronic graft problems, and transplant failure in pediatric transplant patients.
- Recent research using advanced molecular diagnostics has improved our understanding of RVI patterns and results in this vulnerable population.
Conclusions:
- RVIs represent a critical threat to pediatric transplant recipients, necessitating vigilant monitoring and proactive management.
- Continued research and implementation of advanced diagnostics, vaccines, and treatment protocols are vital for reducing RVI-related complications and improving long-term survival.
- Careful consideration of RVI status is important before and after transplantation to optimize patient safety and graft success.
Abstract:
Respiratory viral infections (RVIs) are among the leading cause of morbidity and mortality in pediatric hematopoietic stem cell transplant (HCT) and solid organ transplant (SOT) recipients. Transplant recipients remain at high risk for super imposed bacterial and fungal pneumonia, chronic graft dysfunction, and graft failure as a result of RVIs. Recent multicenter retrospective studies and prospective studies utilizing contemporary molecular diagnostic techniques have better delineated the epidemiology and outcomes of RVIs in pediatric transplant recipients and have advanced the development of preventative vaccines and treatment interventions in this population. In this review, we will define the epidemiology and outcomes of RVIs in SOT and HSCT recipients, describe the available assays for diagnosing a suspected RVI, highlight evolving management and vaccination strategies, review the risk of donor derived RVI in SOT recipients, and discuss considerations for delaying transplantation in the presence of an RVI.
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