Prevention and treatment of infectious complications after solid organ transplantation in children.
Effective prevention, diagnosis, and treatment of infectious diseases after transplantation are key factors contributing to the success of organ transplantation. Most transplant patients experience different kinds of infections during the first year after transplantation. Children are at particular risk of developing some types of infections by virtue of lack of immunity although they may be at risk for other types due the effect of immunosuppressive regimens necessary to prevent rejection. Direct consequences of infections result in syndromes such as mononucleosis, pneumonia, gastroenteritis, hepatitis, among other entities. Indirect consequences are mediated through cytokines, chemokines, and growth factors elaborated by the transplant recipient in response to microbial replication and invasion, which contribute to the net state of immunosuppression among other effects. This review summarizes the major infections that occur after pediatric organ transplantation, highlighting the current treatment and prevention strategies, based on the available data and/or consensus.
Allen
Upton
U
Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada. upton.allen@sickkids.ca
Green
Michael
M
D002648:Child; D006801:Humans; D007114:Immunization; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D017053:Infection Control; D007239:Infections / Q000209:etiology / Q000628:therapy*; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D014019:Tissue Donors