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Pretransplant Donor and Recipient Infectious Challenges

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Challenges in Pediatric Kidney Transplantation

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Abstract

Infections are one of the leading causes of death in pediatric kidney transplant recipients (Foster et al. Transplantation 11:2432–42, 2011). Candidates awaiting kidney transplant are at an increased risk of infections due to immunological abnormalities resulting from the chronic kidney disease (Kato et al. Clin J Am Soc Nephrol 3:1526–33, 2008). Furthermore, patients on dialysis are at risk of unique infections such as catheter-associated access site infections, bloodstream infections, and peritonitis. Congenital anomalies of the kidney and the urinary tract (CAKUT) are frequently associated with urinary tract infections and colonization with multidrug-resistant organisms. Identification and treatment of active and latent infections prior to transplant are critical for preventing overwhelming posttransplant infections.

The goals of pretransplant infectious disease evaluation are to identify and treat active and latent infections, to identify colonization patterns with multidrug-resistant organisms, and to assess immunity against vaccine-preventable diseases. The evaluation informs perioperative antibiotic management plan to prevent perioperative infections and an antimicrobial prophylaxis plan to prevent posttransplant reactivation of latent infections. Additionally, pretransplant evaluation is aimed at screening potential donors for active or latent infections to prevent posttransplant donor-derived infections.

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Authors and Affiliations

  1. Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA

    Sarah Kizilbash

  2. Department of Pediatrics, Seattle Children’s Hospital/University of Washington, Seattle, WA, USA

    Jodi M. Smith

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  1. Department of Pediatrics, Division of Pediatric Nephrology, MUSC Shawn Jenkins Children’s Hospital/Medical University of South Carolina, Charleston, SC, USA

    Katherine E. Twombley

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Kizilbash, S., Smith, J.M. (2021). Pretransplant Donor and Recipient Infectious Challenges. In: Twombley, K.E. (eds) Challenges in Pediatric Kidney Transplantation . Springer, Cham. https://doi.org/10.1007/978-3-030-74783-1_4

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  • DOI: https://doi.org/10.1007/978-3-030-74783-1_4

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