title: Parainfluenza 3 Infections Early After Kidney or Simultaneous Pancreas-Kidney Transplantation.
abstract: Parainfluenza virus (PIV) can cause serious infections after hematopoietic stem cell or lung transplantation. Limited data exist about PIV infections after kidney transplantation. We describe an outbreak of PIV-3 in a transplant unit. During the outbreak, 45 patients were treated on the ward for postoperative care after kidney or simultaneous pancreas-kidney (SPK) transplantation. Overall, 29 patients were tested for respiratory viruses (12 patients with respiratory symptoms, 17 asymptomatic exposed patients) from nasopharyngeal swabs using polymerase chain reaction. PIV-3 infection was confirmed in 12 patients. One patient remained asymptomatic. In others, symptoms were mostly mild upper respiratory tract symptoms and subsided within a few days with symptomatic treatment. Two patients suffered from lower respiratory tract symptoms (dyspnea, hypoxemia, pulmonary infiltrates in chest computed tomography) and required supplemental oxygen. Four of six SPK patients and eight of 39 of kidney transplant patients were infected with PIV (p = 0.04). In patients with follow-up tests, PIV-3 shedding was still detected 11-16 days after diagnosis. Despite rapid isolation of symptomatic patients, PIV-3 findings were diagnosed within 24 days, and the outbreak ceased only after closing the transplant ward temporarily. In conclusion, PIV-3 infections early after kidney or SPK transplantation were mostly mild. PIV-3 easily infected immunosuppressed transplant recipients, with prolonged viral shedding.
authors.affiliation: Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Helanterä
authors.affiliation: Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: V-J
authors.initials: VJ
authors.lastname: Anttila
authors.affiliation: Department of Virology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Loginov
authors.affiliation: Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Lempinen
mesh_terms: D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010224:Parainfluenza Virus 3, Human / Q000472:pathogenicity*; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D011183:Postoperative Complications; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics; D012141:Respiratory Tract Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D012307:Risk Factors
chemical_list: D012367:RNA, Viral
keywords: clinical research/practice; complication: infectious; infection and infectious agents; infectious disease; kidney transplantation/nephrology; pancreas/simultaneous pancreas-kidney transplantation; viral