ESPN 51th Annual Meeting

ESPN 2018


 
INFECTIONS IN CHILDREN AFTER RENAL TRANSPLANTATION
AHMET KAHVECI 1 Z BIRSIN ÖZÇAKAR 2 NILGÜN ÇAKAR 2 BEYZA DOĞANAY ERDOĞAN 3 FATOŞ YALÇINKAYA 2

1- ANKARA UNIVERSITY FACULTY OF MEDICINE, PEDIATRICS, ANKARA TURKEY
2- ANKARA UNIVERSITY FACULTY OF MEDICINE, PEDIATRIC NEPHROLOGY, ANKARA TURKEY
3- ANKARA UNIVERSITY FACULTY OF MEDICINE, BIOISTATISTICS, ANKARA TURKEY
 
Introduction:

 

Despite reduced acute allograft rejection rates with improvement in immunosupression, infections continue to be a serious complication for pediatric renal transplant recipients (RTR).   In this study, we aimed to evaluate the prevalence, etiology and the association of infections with rejection and eGFR

Material and methods:

 

The files of the patients who were transplanted between March 2008 and March 2017 were retrospectively investigated.

Results:

 The study group consisted of 62 (28 female; 71% of the organs coming from living donors) renal transplant patients. Post transplant infection developed in 51 (82%) patients with a median follow up of 50 (3-156) months. Forty three (69%) patients had bacterial infections including 27 (63%) with urinary tract infection (UTI). Of the patients with UTI 67% had recurrence and 33% lower urinary tract dysfunction (LUTD). In addition, 2 of the three patients who developed E Coli bacteriemia in the first month of transplantation were due to UTI. The second most common infection was tonsillitis seen in 39% of the cases following with pneumonia and otitis in 24% and 9% , respectively. Twenty seven (44%) patients developed viral infections during follow up. CMV was the most prevalent viral infection seen in 12 (19%) patients. Subsequently,7 patients had influenza and 5 developed zona zoster. BK viremia was diagnosed in five patients, nephropathy developed in one of them. Other less common infections seen in the study group were herpes simplex, chicken pox, EBV and others. Ten of the 62 patients developed cellular rejection. Antibody mediated, mixed type rejection and chronic allograft nephropathy were diagnosed in 4, 2 and 2 patients, respectively. No association was found between the infection and eGFR/rejection episodes. 

Conclusions:

 

The frequency of infectious complications remains high in pediatric RTR.  Urinary tract infections are still the most common infections causing significant morbidity with recurrence and LUTD in childhood.