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Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants
Author(s) -
Al Khasawneh Eihab,
Araya Carlos E.,
Dharnidharka Vikas R.
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2012.01773.x
Subject(s) - medicine , immunosuppression , odds ratio , incidence (geometry) , viral load , pediatrics , viral shedding , confidence interval , immunology , virus , physics , optics
Al Khasawneh E, Araya CE, Dharnidharka VR. 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.