Management of pediatric postrenal transplantation infections

Infections are the leading cause of hospitalization and death after renal transplantation in children. Various agents are implicated in posttransplantation infections. Viral infections due to the cytomegalovirus and Epstein-Barr virus have assumed greater importance as other infections such as pneumocystis pneumonia have come under control. Multiple factors contribute to the difficulty in the prevention, diagnosis, and treatment of pediatric postrenal transplantation infections. Prevention of infections by adequate preparation before transplantation and the use of chemoprophylaxis should be made a priority. An aggressive approach to diagnosis is required when investigating fever in children. It is hoped that the use of more specific immunosuppressive agents that block only the alloactivated T cells and leave the rest of the immune response intact may result in a reduction in the number and frequency of infections.