Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Respiratory syncytial virus infections in pediatric renal transplant recipients

  • 59 Accesses

  • 10 Citations


Immunocompromised patients are considered at increased risk from respiratory syncytial virus (RSV) infection. We examined the incidence and outcome of RSV infection in pediatric renal transplant (Tx) recipients on chronic immunosuppressive therapy. Of 173 recipients transplanted between November 1985 and April 1993, 5 (3%) developed RSV infection (age range 11–39 months). Initial immunosuppression included prednisone, azathioprine, cyclosporine, and polyclonal antibody therapy. Time from Tx to onset of RSV infection was 1 day to 7 months. Symptoms included rhinorrhea, cough, tachypnea, retractions, fever, wheezing, and abnormal chest X-ray. Treatment included bronchodilator therapy, bronchial drainage, ribavirin, and mist tent. Azathioprine was transiently withheld for leukopenia during treatment in 2 recipients. Three recipients developed biopsy-proven acute rejection during (n=2) or immediately following (n=1) RSV infection; all responded to corticosteroid treatment. RSV infection is not commonly diagnosed in pediatric renal Tx recipients. The course of RSV infection in our patients did not differ from that reported in normal children. The possible association between RSV and acute rejection warrants further observation. When diagnosed early, RSV infection does not appear to be associated with increased mortality in pediatric renal Tx recipients. Larger numbers of recipients need to be studied to confirm these results.

This is a preview of subscription content, log in to check access.


  1. 1.

    Henderson FW, Collier AM, Clyde WA Jr, Denny FW (1979) Respiratory-syncytial-virus infections, reinfections and immunity. N Engl J Med 300:530–534

  2. 2.

    Hall CB, Geiman JM, Biggar R, Kotok DI, Hogan PM, Douglas RG Jr (1976) Respiratory syncytial virus infections within families. N Engl J Med 294:414–419

  3. 3.

    MacDonald NE, Hall CB, Suffin SC, Alexson C, Starris PH, Manning JA (1982) Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med 307:397–400

  4. 4.

    Hall CB, Powell KR, MacDonald NE, Gala CL, Menegus ME, Suffin SC, Cohen HJ (1986) Respiratory syncytial viral infection in children with compromised immune function. N Engl J Med 315:77–81

  5. 5.

    Ogra PL, Patel J (1988) Respiratory syncytial virus infection and the immunocompromised host. Pediatr Infect Dis J 7:246–249

  6. 6.

    Chadwani S, Borkowsky W, Krasinski K, Lawrence R, Welliver R (1990) Respiratory syncytial virus infection in human immunodeficiency virus-infected children. J Pediatr 117:251–254

  7. 7.

    Milner ME, Monte SM de la, Hutchins GM (1985) Fatal respiratory syncytial virus infection in severe combined immunodeficiency disease. Am J Dis Child 139:1111–1114

  8. 8.

    Jarvis WR, Middleton RJ, Gelfond EW (1983) Sigificance of viral infections in severe combined immunodeficiency. Pediatr Infect Dis J 2:187–192

  9. 9.

    Pohl C, Green M, Wald ER, Ledesma-Medina J (1992) Respiratory syncytial virus infections in pediatric liver transplant recipients. J Infect Dis 165:166–169

  10. 10.

    Englund JA, Sullivan CJ, Jordan MC, Dehner LP, Vercillotti GB, Balfour HH Jr (1988) Respiratory syncytial virus infection in immunocompromised adults. Ann Intern Med 109:203–208

  11. 11.

    Peigue-Lafeuille H, Gazuy N, Mignot P, Deteix P, Beytout D, Baguet JC (1990) Severe respiratory syncytial virus pneumonia in an adult renal transplant recipient: successful treatment with ribavirin. Scand J Infect Dis 22:87–89

  12. 12.

    Solomon LR, Raftery AT, Mallick NP, Johnson RWG, Longson M (1981) Respiratory syncytial virus infection following renal transplantation. J Infect 3:280–282

  13. 13.

    Doud JR, Hinkamp T, Garrity ER Jr (1992) Respiratory syncytial virus pneumonia in a lung transplant recipient: case report. J Heart Lung Transplant 11:77–79

  14. 14.

    Committee on Infectious Diseases (1993) Use of ribaviran in the treatment of respiratory syncitial virus infection. Pediatrics 92:501–504

Download references

Author information

Correspondence to Blanche M. Chavers.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Miller, R.B., Chavers, B.M. Respiratory syncytial virus infections in pediatric renal transplant recipients. Pediatr Nephrol 10, 213–215 (1996). https://doi.org/10.1007/BF00862085

Download citation

Key words

  • Kidney transplant
  • Infection
  • Respiratory syncytial virus
  • Rejection