Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Washington, Fred Hutchinson Cancer Research Center; Department of Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA.
J Pediatric Infect Dis Soc. 2024 Feb 28;13(Supplement_1):S39-S48. doi: 10.1093/jpids/piad094.
Respiratory viral infections (RVIs) are among the leading cause of morbidity and mortality in pediatric hematopoietic stem cell transplant (HCT) and solid organ transplant (SOT) recipients. Transplant recipients remain at high risk for super imposed bacterial and fungal pneumonia, chronic graft dysfunction, and graft failure as a result of RVIs. Recent multicenter retrospective studies and prospective studies utilizing contemporary molecular diagnostic techniques have better delineated the epidemiology and outcomes of RVIs in pediatric transplant recipients and have advanced the development of preventative vaccines and treatment interventions in this population. In this review, we will define the epidemiology and outcomes of RVIs in SOT and HSCT recipients, describe the available assays for diagnosing a suspected RVI, highlight evolving management and vaccination strategies, review the risk of donor derived RVI in SOT recipients, and discuss considerations for delaying transplantation in the presence of an RVI.
呼吸道病毒感染（RVIs）是儿科造血干细胞移植（HCT）和实体器官移植（SOT）受者发病率和死亡率的主要原因之一。移植受者仍面临严重的细菌性和真菌性肺炎、慢性移植物功能障碍以及因 RVIs 导致的移植物失功的风险。最近的多中心回顾性研究和前瞻性研究利用现代分子诊断技术，更好地描述了儿科移植受者中 RVIs 的流行病学和结果，并为该人群开发了预防疫苗和治疗干预措施。在这篇综述中，我们将定义 SOT 和 HCT 受者中 RVIs 的流行病学和结果，描述用于诊断疑似 RVI 的现有检测方法，重点介绍不断发展的管理和疫苗接种策略，回顾 SOT 受者中供体来源 RVI 的风险，并讨论在存在 RVI 时延迟移植的注意事项。
