Respiratory viral detection ups mortality risk in children undergoing liver transplant

Detection of respiratory viruses in children with severe hepatocellular dysfunction during the peri-liver transplant period appears to increase the risk of death and postoperative surgical complications, reveals a recent study.

In total, 169 children (median age 0.9 years) were included in this study. Biliary atresia with liver cirrhosis (47.3 percent) was the primary reason for undergoing liver transplantation. Of the patients, 89.9 percent had a living-donor transplantation.

Of the children, 65 (38.5 percent) had viral detection, with 57 percent detected pretransplant. Adenovirus, parainfluenza, and rhinovirus/enterovirus were the most common viruses detected.

Children with a viral detection were more likely to succumb (20.7 percent vs 8.7 percent; adjusted odds ratio [aOR], 2.56, 95 percent confidence interval [CI], 1.02‒6.42; p=0.03) and experience surgical complications (aOR, 2.18, 95 percent CI, 1.12‒4.27; p=0.02), regardless of the transplant indication or donor type.

Furthermore, bacterial coinfection could increase the likelihood of mortality in children with viral detection (aOR, 2.65, 95 percent CI, 1.06‒6.61; p=0.03).

This retrospective cohort study was conducted between January 2020 and December 2023 at a tertiary university hospital. The investigators included children who underwent multiplex chain reaction testing from 7 days before to 14 days after liver transplantation. They collected data from medical records and laboratory databases.

The association between peri-transplant viral detection and mortality was the primary endpoint.