Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants
Article first published online: 20 AUG 2012
© 2012 John Wiley & Sons A/S.
Volume 17, Issue 2, pages 129–132, March 2013
How to Cite
Al Khasawneh, E., Araya, C. E. and Dharnidharka, V. R. (2013), Missed viral surveillance testing visits associate with full blown viral diseases in children receiving kidney transplants. Pediatric Transplantation, 17: 129–132. doi: 10.1111/j.1399-3046.2012.01773.x
- Issue published online: 26 FEB 2013
- Article first published online: 20 AUG 2012
- Accepted for publication 9 June 2012
- viral surveillance;
- viral replication;
- full blown viral disease
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.