Infectious status of children after renal transplantation and experience of etiotropic treatment of viral complications

Abstract

The article presents the results of viral infections monitoring in children at different times after renal transplantation and experience of their use in treatment of post-transplant complications. This study presents the results of virological investigation of relevant agents of viral infections (CMV, EBV, HSV 1, 2 tons, HHV 6, HHV 7, VZV, ADV, BKV and JCV). The frequency of identifying the viral infections in blood in the early postoperative period (the frst 3 months after transplantation) was 20.0 %, in the late postoperative period – 8.0 %, in the case of graft dysfunction – 21.4 %. According to the results of PCR tests of urine, BK and / or JC viruses were identifed in 40.0 % of recipients in the early postoperative period and in 47.1 % of recipients in the late postoperative period. The dominant pathogens were polyomaviruses, BKV (22.9 %) prevailed in the early postoperative period, and JCV (36.8 %) in the late postoperative period. There are the examples of treatment of acute transplant rejection combined with HHV 6 viremia and graft dysfunction combined with a long-term persistence of BKV infection. The use of vanganciclovir in the frst case and the replacement mycophenolate mofetil (MMF) by azathioprine in the second one allowed stabilizing the function of the transplanted organ.