Varicella-zoster infection in pediatric solid-organ transplant recipients:A hospital-based study in the prevaricella vaccine era

We reviewed 58 cases of varicella-zoster infection that occurred between 19 88 and 1998 in 47 pediatric solid-organ transplant recipients. The median a ge of patients at the time of admission with varicella-zoster infection was 8.0 yr (range 1-17 yr). The median interval between transplantation (Tx) a nd varicella-zoster virus (VZV) infection was 1.6 yr (range 0.06-9.3 yr). V aricella infection occurred at a rate of one case for every seven transplan t recipients. Among the 58 cases of VZV infection, 53% were varicella while 47% were herpes-tester. Varicella infection occurred despite treatment wit h varicella-zoster immune globulin (VZIG) in 17 of 31 cases of varicella in fection. However, the disease was generally mild with severe disease occurr ing in only two patients. One patient (1.7%) died as a result of bacterial sepsis. There was no significant relationship between VZV infection and spe cific immune suppressants. Episodes of rejection were more likely to be tem porally associated with the occurence of herpes tester than with varicella infection (p = 0.02). The data generated provide useful background informat ion in our population in the prevaricella vaccine era.