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P13.13 Pediatric Transplant and SARS Cov2 in a Country with high lethality.

Luciola Vasquez, Peru

pediatrician - nephrologist pediatrician
Organ Transplant Department
Guillermo Almenara Irigoyen Hospital.

Abstract

Pediatric transplant and SARS Cov2 in a country with high lethality

Luciola Vasquez1, Bertha Cardenas1, Wilder Pinto1, Martin Padilla1, Carlos Rondon1, Wilmer Bacilio1, Carmen Cerron1, Monica Samos1.

1Department of Organ Transplantation, Guillermo Almenara Irigoyen National Hospital, Lima, Peru

Introduction: At the time of reporting, Peru has 3'522,444 cases of SARS Cov 2 infection, with a lethality of 5.99%. The official data are 1315 deaths from 0-19 years of age (10-19 years: 700; 53.99%: male). While 74% of the population is fully vaccinated, coverage in the pediatric population is still low: 5-11th: 52.17% (1 dose) and 25.17% (2 doses); 12-17th: 82.334% (1 dose) 68.79% (2 doses) 0.83% (3 doses). Among those awaiting transplantation and transplanted (regardless of age) 1725 (1 dose), 1244 (2 doses) and 227 (3 doses, 13.16%).

Methods: We describe a case series of pediatric transplanted patients (kidney and liver) between March 2020 and December 2021, the population was 114 patients, being the sample 58 patients who met the criteria for the study (pediatric age, SARS Cov2 infection).

Results: 32.76% of pediatric transplant recipients were infected with SARS Cov2. The highest number of cases was in January 2022 (31.58%: 6), 57.89% were female. The mean age for liver transplant recipients was:10.7years and for kidney transplant recipients:14.5years. 63.16% (12) had between 4 to 9 years post-transplantation and only 7.69% (1) had less than 3 months post-transplantation. Most frequent symptoms: rhinorrhea, cough and diarrhea. Complications: pneumonia. Comorbidities:  Diabetes Mellitus (1), HTA (1). The 94.74% (18) were blood group 0+.  Regarding the HLA in renal patients: A (2.24/2.68) B (35/61/ 35.39) DR (4.8), they needed hospitalization: 2 (13.33%), 1 in mechanical ventilation (MV). In relation to immunosuppression: in 61.54% the use of antiproliferative drugs was reduced and suspended in 13.33%, while the use of corticoids was maintained. Of the vaccinated patients, 46.15% were infected. One patient obituated at the beginning of the pandemic who was the first transplanted patient in the hospital to become infected.

Conclusions: Despite the pandemic and the restrictions imposed by the government and hospital regulations and the shortage of donors in the country it was possible to perform 12 transplants (41.66% with living donor), however, they were not the most affected in this pandemic, which reinforces the importance of maintaining isolation.  Mortality in pediatric transplant recipients was similar to that of the country (5.26%). Despite vaccination, there were cases of infection in vaccinated patients, which will show the authorities that pediatric transplant recipients should receive booster vaccination.

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