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A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection.

Publication ,  Journal Article
Danziger-Isakov, L; Steinbach, WJ; Paulsen, G; Munoz, FM; Sweet, LR; Green, M; Michaels, MG; Englund, JA; Murray, A; Halasa, N; Dulek, DE ...
Published in: Journal of the Pediatric Infectious Diseases Society
July 2019

Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear.A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant. An RVI diagnosis required respiratory symptoms and detection of a virus (ie, human rhinovirus/enterovirus, human metapneumovirus, influenza virus, parainfluenza virus, coronavirus, and/or respiratory syncytial virus). The incidence of RVI was calculated, and the association of baseline SOT factors with subsequent pulmonary complications and death was assessed.Of 1096 pediatric SOT recipients (448 liver, 289 kidney, 251 heart, 66 lung, 42 intestine/multivisceral), 159 (14.5%) developed RVI associated with hospitalization within 12 months after their transplant. RVI occurred at the highest rates in intestine/abdominal multivisceral (38%), thoracic (heart/lung) (18.6%), and liver (15.6%) transplant recipients and a lower rate in kidney (5.5%) transplant recipients. RVI was associated with younger median age at transplant (1.72 vs 7.89 years; P < .001) and among liver or kidney transplant recipients with the receipt of a deceased-donor graft compared to a living donor (P = .01). The all-cause and attributable case-fatality rates within 3 months of RVI onset were 4% and 0%, respectively. Multivariable logistic regression models revealed that age was independently associated with increased risk for a pulmonary complication (odds ratio, 1.24 [95% confidence interval, 1.02-1.51]) and that receipt of an intestine/multivisceral transplant was associated with increased risk of all-cause death (odds ratio, 24.54 [95% confidence interval, 1.69-327.96]).In this study, hospital-associated RVI was common in the first year after pediatric SOT and associated with younger age at transplant. All-cause death after RVI was rare, and no definitive attributable death occurred.

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Published In

Journal of the Pediatric Infectious Diseases Society

DOI

EISSN

2048-7207

ISSN

2048-7193

Publication Date

July 2019

Volume

8

Issue

3

Start / End Page

197 / 204

Related Subject Headings

  • Virus Diseases
  • United States
  • Transplant Recipients
  • Rhinovirus
  • Retrospective Studies
  • Respirovirus
  • Respiratory Tract Infections
  • Respiratory Syncytial Viruses
  • Orthomyxoviridae
  • Organ Transplantation
 

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Danziger-Isakov, L., Steinbach, W. J., Paulsen, G., Munoz, F. M., Sweet, L. R., Green, M., … Fisher, B. T. (2019). A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection. Journal of the Pediatric Infectious Diseases Society, 8(3), 197–204. https://doi.org/10.1093/jpids/piy024
Danziger-Isakov, Lara, William J. Steinbach, Grant Paulsen, Flor M. Munoz, Leigh R. Sweet, Michael Green, Marian G. Michaels, et al. “A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection.Journal of the Pediatric Infectious Diseases Society 8, no. 3 (July 2019): 197–204. https://doi.org/10.1093/jpids/piy024.
Danziger-Isakov L, Steinbach WJ, Paulsen G, Munoz FM, Sweet LR, Green M, et al. A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection. Journal of the Pediatric Infectious Diseases Society. 2019 Jul;8(3):197–204.
Danziger-Isakov, Lara, et al. “A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection.Journal of the Pediatric Infectious Diseases Society, vol. 8, no. 3, July 2019, pp. 197–204. Epmc, doi:10.1093/jpids/piy024.
Danziger-Isakov L, Steinbach WJ, Paulsen G, Munoz FM, Sweet LR, Green M, Michaels MG, Englund JA, Murray A, Halasa N, Dulek DE, Madan RP, Herold BC, Fisher BT. A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection. Journal of the Pediatric Infectious Diseases Society. 2019 Jul;8(3):197–204.
Journal cover image

Published In

Journal of the Pediatric Infectious Diseases Society

DOI

EISSN

2048-7207

ISSN

2048-7193

Publication Date

July 2019

Volume

8

Issue

3

Start / End Page

197 / 204

Related Subject Headings

  • Virus Diseases
  • United States
  • Transplant Recipients
  • Rhinovirus
  • Retrospective Studies
  • Respirovirus
  • Respiratory Tract Infections
  • Respiratory Syncytial Viruses
  • Orthomyxoviridae
  • Organ Transplantation