Infectious complications in children after transplantation of solid organs

Abstract

Objective: The objective is an optimization of medical support of children after transplantation of liver and kidneys based on analysis of frequency, etiology and nature of infectious complications.Methods: From 2017 to 2019, 40 transplantations of solid organs were performed in various medical institutions at 38 children, having lived in Novosibirsk region: 23 liver transplantation, 13 kidney transplantation and 2 single-stage transplantation of a part of the liver and the kidney. Imunosuppressive protocol components were lymphocyte non-exhaustion monoclonal antibodies, glucocorticosteroids, calcineurin inhibitor, mycophenolates. Besides immunosuppression right after the transplantation, 78.9 % of patients received Valgancyclovirum under inpatient treatment, and 65.8 % of patients continued taking it under outpatient treatment. In all cases, patients received Co-trimoxazole and Fluconazole for preventive purposes.Results: Right after the organs transplantation 44 cases of infectious complications of different etiology were detected. 39 infectious complications were diagnosed during early post-operative period, including 24 – after the liver transplantation, 15 – after the kidney transplantation. 17 longterm infectious complications were registered, in most cases (64.7 %) – after the liver transplantation. In general there is no significant difference in the frequency of complications after transplantations.Conclusions: Patients, having undergone the transplantation of solid organs, need a dynamic monitoring of markers of different infections. Taking into account persistent nature of infectious complications and high frequency of their occurrence, especially during the first six years, patients need a preventive prescription of Valgancyclovirum and Co-trimoxazole as well as prevention of urinary system infections after the kidney transplantation.