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Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants.

Abstract
Surveillance testing for major viral infections such as CMV, EBV, and BKV early in their natural history course may allow for early intervention and prevention of FBVD, but the testing is expensive and optimal interval/frequency are uncertain. At our center we initiated routine monthly viral surveillance for CMV, EBV, and BKV in July 2008 for the first 12 months post-transplant. Here, we retrospectively analyzed for outcome of the patients who missed three or more surveillance tests in the first 12 months post-transplant vs. those who did not. Of 21 patients, five missed three or more surveillance tests. Two of those five developed FBVD (one BKV nephropathy and one EBV-PTLD). None of the 16 patients with more regular surveillance testing developed FBVD. The incidence of viral replication was similar in both groups. The odds ratio for FBVD if viral surveillance tests were missed was 23.57 (p-value of 0.047). In this small group of contemporaneous patients on identical immunosuppression, those patients who missed regular viral surveillance were more likely to develop FBVD. Prospective randomized trials to confirm the benefit of regular viral testing are recommended.
AuthorsEihab Al Khasawneh, Carlos E Araya, Vikas R Dharnidharka
JournalPediatric transplantation (Pediatr Transplant) Vol. 17 Issue 2 Pg. 129-32 (Mar 2013) ISSN: 1399-3046 [Electronic] Denmark
PMID22905915 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2012 John Wiley & Sons A/S.
Topics
  • Adolescent
  • BK Virus (isolation & purification)
  • Child
  • Child, Preschool
  • Cytomegalovirus Infections (etiology, prevention & control, virology)
  • Epstein-Barr Virus Infections (etiology, prevention & control, virology)
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation
  • Male
  • Odds Ratio
  • Patient Compliance
  • Polyomavirus Infections (etiology, prevention & control, virology)
  • Postoperative Complications (prevention & control, virology)
  • Retrospective Studies
  • Treatment Outcome
  • Tumor Virus Infections (etiology, prevention & control, virology)
  • Viral Load

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