ORIGINAL RESEARCH
Transpl. Int.
Burden of infectious diseases in children during the first year after solid organ transplantation
- NR
Nathalie Rock 1
- JF
jaromil frossard 2
- CV
christian vandelden 1
- GS
G Sparta 3
- SD
stefano di-bernardo 4
- IM
Ines Mack 5
- PP
Paloma PARVEX 1
- CB
christian balmer 3
- DM
daniela marx-berger 6
- CB
christoph berger 3
- HC
hassib chehade 4
- MS
mace schuurmans 7
- ST
sibylle tschumi 8
- NM
Nicolas Müller 7
- VM
Valérie McLin 1
- AL
arnaud lhuillier 1
- IN
in name of the STCS 9
1. Hôpitaux universitaires de Genève (HUG), Genève, Switzerland
2. Universitatsspital Basel, Basel, Switzerland
3. Universitats-Kinderspital Zurich, Zürich, Switzerland
4. Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
5. Universitats-Kinderspital beider Basel, Basel, Switzerland
6. Ostschweizer Kinderspital, St. Gallen, Switzerland
7. UniversitatsSpital Zurich, Zürich, Switzerland
8. Inselspital Universitatsspital Bern, Bern, Switzerland
9. Universitat Basel, Basel, Switzerland
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Abstract
Background: Infections are a leading cause of morbidity and mortality in pediatric solid organ transplant recipients (SOT). Comprehensive data in this population is limited. Methods: We included pediatric SOT aged 0-18 years prospectively from 2008 to 2022. Using standardized definitions, all clinically relevant infections during the first year after transplant were analyzed. Associations with age, organ type, and rejection episodes were assessed. Results: A total of 285 pediatric SOT were included, with kidney (41%) and liver (37%) transplants being the most common. During the first-year post-transplant, 53% (151/285) of patients experienced at least one infection, totaling 360. The overall incidence was 1.36 infection/person/year. Viral infections predominated (53%) followed by bacterial (41%) and fungal infections (6%). Patients receiving liver and lung transplants had higher infection rates (1.91 and 2.53 per person-year, respectively). In multivariate analysis type of transplant and male sex were associated with risk of infection. Viral infections were overrepresented in younger recipients, while bacterial infections were most frequent in the first three months post-transplant. Conclusions: Pediatric SOT recipients face a substantial burden of infection, with about half experiencing at least one episode in the first post-transplant year. Younger male children and liver or lung recipients were at highest risk.
Summary
Keywords
IMMUNOSUPPRESION, infection, Opportunistic infection, pediatric, solid organ transplant (SOT)
Received
16 December 2025
Accepted
22 April 2026
Copyright
© 2026 Rock, frossard, vandelden, Sparta, di-bernardo, Mack, PARVEX, balmer, marx-berger, berger, chehade, schuurmans, tschumi, Müller, McLin, lhuillier and of the STCS. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Nathalie Rock, nathalie.rock@hug.ch
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