Infections in pediatric kidney and liver transplant patients after perioperative hospitalization.
BACKGROUND
Infectious complications are a major cause of morbidity and mortality after organ transplantation. There are several reports on infections during the first months after transplantation, but there are very few data regarding infections in long-term survivors of pediatric organ transplantation.


METHODS
The incidence and type of infections were retrospectively analyzed in 56 children who underwent 59 liver or renal transplantations. Follow-up was begun when the patient was sent home after a successful operation. All of the children received triple immunosuppression.


RESULTS
During a mean follow-up of 4.8 years (total, 286 patient years), 1540 episodes of infection were recorded. The median incidence was 4.8 episodes/patient year. The greatest number was seen in the smallest children, 3 to 6 months after transplantation. Viral upper respiratory tract infections were the most common problem, accounting for half of the episodes (2.7 episodes/patient year). Gastroenteritis was the second most common viral infection. Only 45 episodes of infection with herpesviruses were recorded, and seven of those were caused by cytomegalovirus. Otitis media and sinusitis were the most common bacterial infections and complicated upper respiratory infection in 23% of episodes. Thirty-nine episodes of urinary tract infections were diagnosed, thirty-one in children with renal transplants. Other bacterial infections were rare, and only three episodes of verified bacterial sepsis were diagnosed.


CONCLUSIONS
The frequency and type of infections in children with liver and renal transplants who are on triple immunosuppression are quite similar to those in age-matched healthy children.
Their
M
M
Hospital for Children and Adolescents, University of Helsinki, Finland.
Holmberg
C
C
Lautenschlager
I
I
Höckerstedt
K
K
Jalanko
H
H
D000293:Adolescent; D001424:Bacterial Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D006566:Herpesviridae Infections / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012016:Reference Values; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012189:Retrospective Studies