Viral Infections After Kidney Transplantation in a Cohort of Children: A Retrospective Single-Center Study

Abstract

BackgroundViral infections are known to be common complications after kidney transplant (KTx), causing significant numbers of mortality and morbidity. ObjectivesWe aimed to highlight the pattern of viral infections after KTx in children and its impact on allograft function. MethodsWe included children who underwent KTx between 2012 and 2017. Baseline demographics, immunosuppressive agents, episodes of viral infections with cytomegalovirus (CMV), BK virus, and Epstein-Barr virus (EBV), and serum creatinine were collected. All children received induction agent followed by maintenance immunosuppression. Oral valganciclovir was given to all high-risk patients for CMV for 180 days as prophylaxis. CMV and EBV polymerase chain reactions were monitored every 2 weeks initially until the ninth month, then monthly until the end of the second year, and then every 3 months. Urine BKV polymerase chain reactions were monitored monthly in the first year and then every 3 months. ResultsA total of 18 children received transplants. There was 1 episode of CMV infection (5.6%), 2 episodes (11.1%) of isolated BK viruria (1 of the 2 with an episode of BK viremia [5.6%] with no associated BK nephropathy [0%]), and no episodes of EBV or lymphoproliferative disease (0%). Allograft functions continued to be stable with mean serum creatinine of 52.2 μmol/L during the study period with 2 episodes (11.1%) of acute cellular rejection and 1 episode (5.6%) of early antibody-mediated rejection. ConclusionProlonged prophylaxis and strict viral monitoring protocol can be effective ways of controlling viral infections after KTx.