Objectives: Viral infections are leading cause of post-transplantation morbidity and mortality. We aimed to determine the effect on graft function, the risk factors, the frequency and types of viral infections, and evaluating the impact of viral infections on kidney and patient outcomes in pediatric kidney transplant patients.
Methods: Records of children undergoing kidney transplantation in our center between 2010-2023 were retrospectively evaluated. Demographic and laboratory data, kidney failure etiologies, donor types, immunosuppressive treatments, acute rejection episodes, accompanying viral infections, glomerular filtration rate, and graft loss rate were analyzed.
Results: Seventy-nine pediatric kidney transplant recipients were included in the study. The number of patients who experienced viral infections was 18 (23%). In total, 25 infection episodes were identified, with 6 (24%) attributed to CMV infection, 8 (32%) to BKV infection, 6 (24%) to Varicella Zoster virus infection (4 cases of shingles, 2 cases of chickenpox), 4 (16%) to Parvovirus B19 infection, and 2 (8%) to COVID-19. Out of 25 infection episodes, rejection episodes were observed in 11 (44%) cases, and infections manifested after rejection in 8 (32%) cases. Viral infections occurred an average of 15 months after rejection episodes. Within 15 (60%) out of the 25 infection episodes, the glomerular filtration rate (GFR) was observed to be <60 ml/min/1.73m² during viral infection. Two patients succumbed to viral infections, one due to COVID-19 and the other to Parvovirus B19 infection /CMV co-infection.
Conclusion: Our data emphasize the significant impact of viral infections on pediatric kidney transplant recipients. Early diagnosis and treatment in kidney transplant recipients are important, and clinicians should be alert.