Clinical-epidemiological analysis of infections in pediatric patients with liver and heart trasplants

Abstract

Background: Liver and heart transplantation represents the definitive treatment for end-stage failure of these organs. In recent years, an increasing number of pediatric patients have undergone these procedures, which are associated with various complications. Among them, infections stand out as one of the main causes of morbidity and mortality. Aim: To describe the infections that affect pediatric recipients of liver and heart transplants (Tx.). Methods: A characterization of the type and timing of infections identified in 31 children who underwent heart transplantation and 27 who underwent liver transplantation at a tertiary university hospital since 2002 (cardiac Tx) and 2009 (hepatic Tx), both to 2023 is presented. Results: Biliary atresia and dilated cardiomyopathy were the main reasons for liver and heart transplantation, respectively. Bacterial infections predominated during the first month after these surgical procedures, while viral infections predominated later. Bacterial infections in general, and bacteriemia were more common in liver Tx. recipients. Cytomegalovirus (CMV) and Epstein-Barr virus, mainly in the form of reactivations, were the most frequently identified viruses, with a higher frequency of CMV in liver Tx. recipients. One patient from each group died in a late period due to bacterial sepsis, without a specific agent identified. Conclusion: The preponderance of infections due to latent viral agents, such as CMV, in pediatric liver or heart transplant recipients, reveals the need to optimize the management of these infections in this growing population in Chile.