RSV prevention and treatment in pediatric lung transplant patients: a survey of current practices among the International Pediatric Lung Transplant Collaborative.
RSV infection can be severe after pediatric lung transplantation. Strategies to prevent and treat RSV in this population are underreported. To assess the current practices, we surveyed the members of the IPLTC regarding RSV prevention and treatment strategies. Twenty-eight programs were surveyed; 18 (64.3%) responded at least partially. A median of 53 transplants (range, 8-355) occurred since inception. RSV testing occurs in asymptomatic (6/17) and symptomatic (17/17) patients. Diagnostic method is polymerase chain reaction at 13 sites and DFA at 8. Transplant candidates were received prophylaxis at 10 sites, with nine following national (5) or local (4) guidelines. All use palivizumab IM and/or IV. Recipients were received prophylaxis with palivizumab at eight centers (eight IM, one IV). Fourteen were treated for RSV (seven all patients; seven age-related). Medications include inhaled (6), oral (4), or IV (4) ribavirin, plus IVIG (9), steroids (8), and IV (2) or IM (3) palivizumab. Prevention and treatment barriers include insurance/hospital concerns, such as institutional reluctance to use inhaled ribavirin. RSV prevention and treatment strategies are diverse at pediatric lung transplant programs. Many centers offer prophylaxis (9/17) and treatments (14/17), but strategies are not uniform.
Cleveland Clinic, Cleveland, OH, USA.
Lara A
LA
Danziger-Isakov
Defne
D
Arslan
Stuart
S
Sweet
Christian
C
Benden
Samuel
S
Goldfarb
Jackson
J
Wong
D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000998:Antiviral Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007391:International Cooperation; D008171:Lung Diseases / Q000150:complications / Q000628:therapy*; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D000069455:Palivizumab; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000517:prevention & control*; D012136:Respiratory Syncytial Viruses / Q000378:metabolism; D012254:Ribavirin / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D012254:Ribavirin; D000069455:Palivizumab