Kidney transplant after hematopoietic cell transplant in pediatrics: Infectious and immunosuppressive considerations.
Pediatr Transplant 2017 Apr 27. Epub 2017 Apr 27.
Department of Pediatrics, Division of Nephrology, University of Minnesota, Minneapolis, MN, USA.
Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis. Read More