Related Experiment Video
Updated: Jul 24, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Complications by age in primary pediatric renal transplant recipients
B M Chavers1, K J Gillingham, A J Matas
1Department of Pediatrics, University of Minnesota Medical Center, Minneapolis 55455, USA.
Insights
Pediatric renal transplant recipients under 2 years old face a higher risk of bacterial infections post-transplant. Hospital readmissions and viral infections did not significantly differ by age group in this study.
Area of Science:
- Pediatric Nephrology
- Transplant Immunology
- Infectious Diseases
Background:
- Pediatric renal transplantation is a vital treatment for end-stage renal disease.
- Understanding post-transplant complications, particularly infections, is crucial for optimizing outcomes in young patients.
- Age-related differences in readmission rates and infectious complications require investigation.
Purpose of the Study:
- To determine if pediatric renal transplant recipients, stratified by age, exhibit variations in hospital readmissions and infectious complications.
- To identify specific age groups at higher risk for post-transplant infections.
Main Methods:
- Retrospective analysis of 164 pediatric patients (<18 years) undergoing primary renal transplants between 1985 and 1993.
- Cyclosporine-based immunosuppression was used.
- Patients were subgrouped by age to compare readmission rates, length of stay, and incidence of bacterial and viral infections.
Main Results:
- No significant differences in readmission rates or length of hospital stay were observed across age groups.
- Younger recipients (< 2 years) had a significantly higher incidence of bacterial infections (87%) compared to older groups.
- Acute rejection rates were higher in recipients aged 2 years or older.
- Common bacterial infections varied by age: Clostridium difficile-associated diarrhea in younger children (<5 years) and urinary tract infections in older children (>5 years).
- Viral infection incidence did not differ by age, with varicella common in younger and cytomegalovirus in older recipients.
Conclusions:
- Pediatric renal transplant recipients under 2 years of age are at a significantly increased risk for bacterial infections post-transplant.
- Age is a critical factor influencing infection risk, with younger children requiring closer monitoring for bacterial complications.
- While readmission rates were similar, targeted strategies for infection prevention in very young transplant recipients are warranted.
Abstract:
We asked whether pediatric renal transplant recipients, subgrouped by age, differed in the percentage and number of hospital readmissions and in the incidence of infectious complications post transplant. Between 1 August 1985 and 31 October 1993, a total of 164 patients < 18 years of age underwent primary transplants, with cyclosporine-based immunosuppression, at the University of Minnesota. The percentage of readmissions (P = NS), the mean number of readmissions (P = NS), and the length of hospital stay during readmissions (P = NS) did not differ significantly among age groups. The overall incidence of acute rejection was greater in those > or = 2 years than those < 2 years (P = 0.002), and in living donor recipients > or = 2 years versus those < 2 years (P = 0.02). The incidence of bacterial infection (< 2 years, 87%; 2-5 years, 72%; 6-12 years, 51%; 13-17 years, 40%) was greater in younger recipients (P = 0.0001). The most common bacterial infection in recipients < or = 5 years was Clostridium difficile-associated diarrhea; in those > 5 years, urinary tract infection. The overall incidence of viral infection did not differ among groups (P = NS). The most common viral infection in recipients < or = 5 years was varicella and those > 5 years, cytomegalovirus infection. Risk factors for infection in the first 6 months post transplant included age < 2 years and Solu-Medrol treatment for acute rejection. In conclusion, young recipients < 2 years of age at the time of transplant are at a higher risk for bacterial infection post transplant.
Related Concept Videos
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:29Acute Kidney Injury III: Clinical Manifestations