Early infections in children following renal transplantation

BACKGROUND: Infections following renal transplantation in children are a major cause of severe morbidity and mortality. Surgery is complex and performed in a subject whose immunological mechanisms are impaired by end stage renal failure and immunosuppressive drugs. AIM: To evaluate the incidence and the risk factors of early infectious following renal transplantation in children. METHODS: Infectious complications were retrospectively monitored in 37 children receiving renal transplantation at our center from 1992 to 2008. RESULTS: Infectious complications identified were dominated by urinary tract infections occurred in 12 patients. The clinical symptomatology is dominated by fever and decrease in health. In 4 patients the urinary infection was asymptomatic. Three patients had pneumonia; the diagnosis was suspected clinically and confirmed by the chest radiography. Three other patients developed sepsis. In one of them, the etiology was a peritonitis related to dialysis catheter. Two transplant showed a herpetic cheilitis and one patient developed a parvovirus infection that evolved well after two transfusions. In all cases, the outcome was favourable with no deaths or impact on graft function. CONCLUSION: After renal transplantation, the disturbance of inflammatory reactions explains the often latent or delayed infectious process making early diagnosis difficult. It is imperative to monitor infectious to minimize morbidity and mortality.