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Monitoring and managing viral infections in pediatric renal transplant recipients

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Abstract

Viral infections remain a significant cause of morbidity and mortality following renal transplantation. The pediatric cohort is at high risk of developing virus-related complications due to immunological naiveté and the increased alloreactivity risk that requires maintaining a heavily immunosuppressive environment. Although cytomegalovirus is the most common opportunistic pathogen seen in transplant recipients, numerous other viruses may affect clinical outcome. Recent technological advances and novel antiviral therapy have allowed implementation of viral and immunological monitoring protocols and adoption of prophylactic or preemptive treatment approaches in high-risk groups. These strategies have led to improved viral infection management in the immunocompromised host, with significant impact on outcome. We review the major viral infections seen following kidney transplantation and discuss strategies for preventing and managing these pathogens.

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Acknowledgments

This study was partly supported by grants from the Associazione Italiana per la Ricerca sul Cancro (AIRC) to PC; Ministero della Salute: Progetti Ricerca Oncologica [grant numbers RFPS-2006-4-341763 to PC; RFPS-2006-Regione Umbria to PC], and Progetti Ricerca Finalizzata; grant from Agenzia Italiana del Farmaco to FG; Fondazione IRCCS Istituto Gaslini, Progetti di Ricerca Corrente to FG; and Fondazione Malattie Renali del Bambino, Genova, to FG. We thank Laurene Kelly for manuscript editing.

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  1. Pediatric Hematology/Oncology and Research Laboratories, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy

    Patrizia Comoli

  2. Clinical and Experimental Kidney Transplantation Unit, Istituto G. Gaslini, Genova, Italy

    Fabrizio Ginevri

  3. UOS Medicina Clinica e Sperimentale dei Trapianti d’Organo, Unità Operativa di Nefrologia, Istituto G. Gaslini, Largo Gaslini 5, 16147, Genova, Italy

    Fabrizio Ginevri

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  1. Patrizia Comoli
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  2. Fabrizio Ginevri
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Correspondence to Fabrizio Ginevri.

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Comoli, P., Ginevri, F. Monitoring and managing viral infections in pediatric renal transplant recipients. Pediatr Nephrol 27, 705–717 (2012). https://doi.org/10.1007/s00467-011-1812-2

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  • DOI: https://doi.org/10.1007/s00467-011-1812-2

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