Varicella is a common childhood disease that can cause morbidity and mortality among immunosuppressed patients. There have been few previous studies monitoring the course of pediatric
liver transplant patients with acute
varicella. The aim of this study was to evaluate the treatment, outcomes, and complications of pediatric
liver transplant patients admitted with acute
varicella infection.
METHODS: A retrospective chart review was carried out based on discharge diagnoses of orthotopic
liver transplant and
varicella among pediatric patients (age range, birth-18 years) admitted to the UCLA Medical Center between 1985 and 2001.
RESULTS: Five hundred fifty-six pediatric patients received
liver transplantations between 1985 and 2001. Twenty-two of these patients were admitted to the UCLA Medical Center with
varicella (11 females, 11 males). No patients were treated on an outpatient basis. Mean age of the patients was 6 years (range, 1-16 years). None of these patients received the
varicella vaccine before hospitalization. On admission, 5 of 22 patients (23%) had received
varicella zoster immunoglobulin within 96 hours of exposure. The mean length of hospitalization was 6 days (range, 2-11 days). All immunosuppression dosages were reduced during the admissions. None of the patients had been treated with high-dose
corticosteroids for acute rejection before the onset of the
varicella infection. Patients were treated until defervescence with intravenous
acyclovir and until their
varicella lesions crusted. Patients were discharged with oral
acyclovir to complete a 10-day course (including the intravenous treatment). No patients had complications from the
varicella infection. A complication of an elevated serum
creatinine for one patient was noted with the intravenous
acyclovir treatment. This patient had associated
headache and
nausea that resolved when the
creatinine level returned to normal.
CONCLUSIONS: