OPPORTUNISTIC INFECTIONS FOLLOWING INDUCTION THERAPY WITH BASILIXIMAB IN PEDIATRIC LIVER TRANSPLANT RECIPIENTS

O. Len, J. Bueno, M. Falcone, J. Gavaldí , J. Ortega, C. Margarit, J. Balsells, R. Dí­ez-Dorado, A. Pahissa.

Author address: 

Pediatric Liver Transplantation Unit, Hospital Vall d’Hebron, Barcelona, Spain.

Abstract: 

Background: Information regarding opportunistic infections in pediatric liver transplant recipients is scarce. We assessed the epidemiology and risk of infection in a large cohort of pediatric liver transplant recipients that received tacrolimus-based steroid-free immunosuppressive protocol using an induction treatment with basiliximab for the prevention of acute allograft rejection . Methods: All recipients who received basiliximab from January 2000 through December 2006 as induction therapy at the time of transplantation were evaluated for the development of an opportunistic infections until death or for 24 months after procedure. Results: 62 liver transplants were performed in 56 recipients. Mean age was 3.9 years with 17 (30.6%) patients under one year old. Overall, 21 recipients (33.9%) developed 30 opportunistic infections . Viral infection accounted for 90% (27/30) of the episodes: cytomegalovirus disease (8 viral syndrome, 1 pneumonia, 1 hepatitis and 1 disseminated), Epstein-Barr virus febrile syndrome (8 cases), adenovirus (2 colitis and 1 viral syndrome), 2 syncitial respiratory virus pneumonia, human herpesvirus 6 infection (1 case), one episode of chickenpox and one herpes simplex virus localized infection. Nearly half the episodes of viral infection occurred 6 months after transplantation. Fungal infection was responsible of 3 opportunistic infections episodes: one esophageal candidiasis, one disseminated candidiasis and one pulmonary invasive aspergillosis. Four patients (19%) died due to infection (two of them affected of invasive fungal disease). Acute rejection (OR 3.5; 95% CI: 1.1-11.8) was the only independent predictor for the development of an opportunistic infections . There were also 4 episodes of posttransplant lymphoproliferative disease. Conclusions: Viral infections (mostly due to herpesvirus) are the main etiology for opportunistic infections, ocurring in the late posttransplant period. Acute rejection was the only independent risk factor associated to opportunistic infections
2007

abstract No: 

K-1762

Full conference title: 

47th Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 47th