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Infections Following Kidney Transplant in Children: A Single-Center Study

2014; Scientific Research Publishing; Volume: 04; Issue: 03 Linguagem: Inglês

10.4236/ojneph.2014.43017

2164-2842

Alexandre Ribeiro Fernandes, Liliana Rocha, Teresa Costa, Paula Matos, Maria Faria, Lino Marques, Conceição Mota, António Castro Henriques,

Polyomavirus and related diseases

Introduction: Infections are a major cause of morbidity and mortality in pediatric patients undergoing kidney transplantation (KT). Aim and Methods: To determine the patterns of infectious complications during the first 6 months post transplantation, we report our single center experience with data from pediatric kidney recipients transplanted between 2006 and 2011. Results: Thirty-two children (20 males) were submitted to KT. The most common cause of end-stage renal disease (ESRD) was congenital anomalies of the kidney and urinary tract (CAKUT) accounting for 62%. Over the first 6 months post-transplant period, twenty-eight (87.5%) children developed a total of 77 infections, mainly urinary tract infections (UTI) (64.9%). CAKUT etiology of ESRD and UTI before KT increased the risk to develop more than one episode of UTI [71.4% vs. 14.3% and 81.8% vs. 18.2%, respectively; p < 0.05]. Twenty-three (29.9%) viral infections occurred. Cytomegalovirus (CMV) was the most common opportunistic pathogen, occurred in 11 patients and was more frequently in those with a donor (D)+/recipient (R)- CMV sero-status [74.5% vs. 25.5% (p < 0.05)]. A polyomaviruses (BKV) disease with nephropathy and meningitis was registered. The majority of infectious episodes had mild or moderate severity. No deaths occurred. Conclusion: A significant number of patients presented infectious complications during the first 6 months post transplantation. UTI are the most common type of infection, followed by viral infections, particularly CMV. Recognition, prevention and early treatment of infections are of major importance.