Diagnoses and Timelines in Pediatric Liver Transplant Recipients With Suspected Acute Infections

Area of Science:

• Pediatric Gastroenterology and Hepatology
• Transplant Infectious Diseases

Background:

• Infections are a significant cause of illness following pediatric liver transplantation (LT).
• Existing data on post-LT infections primarily focus on the initial three months, leaving a gap in knowledge for long-term outcomes.

Purpose of the Study:

• To characterize the incidence and types of acute infections requiring unscheduled visits in pediatric liver transplant recipients beyond the early post-transplant period.
• To identify common infectious etiologies and potential non-infectious mimics.

Main Methods:

• Retrospective review of electronic health records for pediatric liver transplant recipients.
• Analysis of unscheduled visits for suspected acute infections occurring after the initial 3-month post-transplant period.
• Categorization of diagnoses into infectious (viral respiratory, enteric, skin) and non-infectious causes.

Main Results:

• Out of 315 LT recipients, 135 (42.9%) had unscheduled visits for suspected infections.
• A total of 342 such visits were recorded.
• The most frequent diagnoses were viral respiratory infections (33.9%), enteric infections (29.8%), and skin infections (8.2%).
• Non-infectious conditions like rejection and ileus were also noted as reasons for visits.

Conclusions:

• Infections remain a common reason for unscheduled medical visits in pediatric liver transplant recipients long after transplantation.
• Viral respiratory and enteric infections are the predominant infectious causes.
• Distinguishing infections from non-infectious mimics is important for appropriate management.