Hogan J, et al. - In a national pediatric kidney transplantation cohort, posttransplant infections requiring hospitalization, their risk factors as well as cost were described. The reported burden of infection in transplanted pediatric patients was high, especially among the youngest. For pretransplantation information and designing procedures aiming to decrease hospitalization rate and duration, this finding should be considered.

Methods

• Researchers, using the French National Medicoadministrative Hospital Discharge database, extracted data on renal transplant recipients <20 years between 2008 and 2013 and matched it with the Renal Transplant Database.
• They studied risk factors of hospitalization, using Cox regression.
• In addition, they calculated the instantaneous risk of hospitalization per month for all infections and by infection type.

Results

• This analysis included a total of 593 patients.
• According to data, 660 infection-related hospitalizations were identified in 260 patients.
• Urinary tract infection (UTI), followed by viral infection (16.6 and 15.6 per 100 person-years, respectively) was identified as the leading cause of hospitalization.
• Younger age at transplantation, high number of HLA mismatches, and use cyclosporine rather than tacrolimus as first anticalcineurin treatment were the factors that conferred risk.
• It was also evident that risk factors varied by infection type.
• Researchers found that an increased risk of UTI was related to female gender, uropathy, cold ischemia time, and cyclosporine, while only age at transplantation inversely correlated with virus-related hospitalizations.
• Except for cytomegalovirus (CMV) infection that displayed a peak at 6 months posttransplantation after prophylaxis withdrawal, it was noted that instantaneous risk of all infections decreased with time.
• In addition, total cost of infection-related hospitalizations was 1600 kilo-euro (k€) (933 €/person-years).