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. 2025 Mar 12;44(8):e285-e290.
doi: 10.1097/INF.0000000000004795.

Association Between Mortality and Detection of Respiratory Viruses in Children During the Peri-Liver Transplant Period

Juan Sebastian Calderón Cárdenas  1 , Juan David Bustos  2 , Martha I Álvarez-Olmos  1 , Jairo Rivera  3 , Natalia Lucena  2 , Maira Ureña  3 , María Alejandra Prieto  3 , Jaime Fernández-Sarmiento  2
Affiliations

Association Between Mortality and Detection of Respiratory Viruses in Children During the Peri-Liver Transplant Period

Juan Sebastian Calderón Cárdenas et al. Pediatr Infect Dis J. .

Abstract

Background: To evaluate the disease burden, risk of complications and mortality in children with viral detection during the peri-liver transplant period.

Methods: A retrospective cohort study was conducted between January 2020 and December 2023 at a tertiary university hospital. Children who underwent multiplex polymerase chain reaction testing from 7 days before to 14 days after liver transplantation were included. The primary outcome was the association between peri-transplant viral detection and mortality. Data were obtained from the hospital's medical records and laboratory databases.

Results: A total of 169 children with a median age of 0.9 (interquartile range, 0.5-7.1) years were included. The primary indication for liver transplantation was biliary atresia with liver cirrhosis (47.3%). Living-donor transplantation was performed in 89.9% of cases. Viral detection occurred in 38.5% (65/169) of children, with 57% detected pre-transplant. The most frequently identified viruses were rhinovirus/enterovirus, adenovirus and parainfluenza. Children with viral detection had higher odds of mortality [20% vs. 8.7%; adjusted odds ratio (aOR), 2.56 (95% confidence interval [CI], 1.02-6.42); P = 0.03] and surgical complications [aOR, 2.18 (95% CI, 1.12-4.27); P = 0.02], regardless of the transplant indication or donor type. Bacterial coinfection further increased the odds of mortality in the viral detection group [aOR, 2.64 (95% CI, 1.06-6.61); P = 0.03].

Conclusions: In children with severe hepatocellular dysfunction undergoing liver transplantation, respiratory viral detection during the peri-transplant period was associated with an increased risk of mortality and postoperative surgical complications.

Keywords: children; liver transplantation; mortality; respiratory infection; virus.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

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