Ranawaka R, Dayasiri K, Sandamali E, Gamage M. Management strategies for common viral infections in pediatric renal transplant recipients. World J Transplant 2024; 14(1): 89978 [PMID: 38576764 DOI: 10.5500/wjt.v14.i1.89978]
Corresponding Author of This Article
Randula Ranawaka, MBBS, MD, Chief Physician, Professor, Senior Researcher, Department of Paediatrics, Faculty of Medicine, University of Colombo and Lady Ridgeway Hospital for Children, Kynsey Road, Colombo 0094, Sri Lanka. randula@pdt.cmb.ac.lk
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Randula Ranawaka, Department of Paediatrics, Faculty of Medicine, University of Colombo and Lady Ridgeway Hospital for Children, Colombo 0094, Sri Lanka
Kavinda Dayasiri, Department of Paediatrics, Facullty of Medicine, University of Kelaniya, Ragama 0094, Sri Lanka
Erandima Sandamali, Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle 0094, Sri Lanka
Manoji Gamage, Division of Nutrition, Ministry of Health, Colombo 0094, Sri Lanka
Author contributions: Ranawaka R, Dayasiri K, Sandamali E, Gamage M performed literature survey; Ranawaka R, Dayasiri K, Sandamali E, Gamage M wrote the manuscript; Ranawaka R edited the final version of the manuscript; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Randula Ranawaka, MBBS, MD, Chief Physician, Professor, Senior Researcher, Department of Paediatrics, Faculty of Medicine, University of Colombo and Lady Ridgeway Hospital for Children, Kynsey Road, Colombo 0094, Sri Lanka. randula@pdt.cmb.ac.lk
Received: November 20, 2023 Peer-review started: November 20, 2023 First decision: December 11, 2023 Revised: December 19, 2023 Accepted: January 4, 2024 Article in press: January 4, 2024 Published online: March 18, 2024 Processing time: 116 Days and 4.1 Hours
Abstract
Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort. Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes. Hence, prevention, early detection, and prompt treatment of such infections are of paramount importance. Among all viral infections, herpes viruses (herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus), hepatitis B and C viruses, BK polyomavirus, and respiratory viruses (respiratory syncytial virus, parainfluenza virus, influenza virus and adenovirus) are common in kidney transplant recipients. These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome. Recent advances in technology and antiviral therapy have improved management strategies in screening, monitoring, adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host, with significant impact on the outcome. This review discusses the etiology, screening and monitoring, diagnosis, prevention, and treatment of common viral infections in pediatric renal transplant recipients.
Core Tip: Pediatric renal transplant recipients are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes. Prevention, early detection, and prompt treatment of such infections are important. Recent advances in technology and antiviral therapy have improved management strategies in screening, monitoring, adoption of preemptive therapy and precise treatment in the immunocompromised host, with significant impact on the outcome.
