Infections are one of the most common problems that occur after transplantation and their prevention often is easier than their treatment. Transplanted patients have an increased risk of infection due to the administration of anti-rejection drugs. The latter reduce the body’s capacity to fight against foreign bodies, graft or bacteria, in a non-specific manner.

Infections can be caused by bacteria or by viruses. Viral infections, be it CMV (cytomegalovirus) or herpes, usually affect the mouth or the transplanted liver. In general, they are treated using drugs administered orally or by the intravenous route for 10 to 14 days. Pneumocystis carinii pneumonia (PCP) is a pulmonary infection due to a parasite. PCP is a type of pneumonia that occurs most commonly in patients with altered immune system. It generally occurs during the first year after the graft when the levels of anti-rejection drugs are highest. All transplanted patients take a drug intended to reduce the risks of developing Pneumocystis pneumonia. The patients take Bactrim® 3x/week (in general, on Mondays, Wednesdays and Fridays) or an aerosolised formulation of pentamidine once per month to prevent the occurrence of PCP pneumonia. This treatment is continued during one year after the graft.

Children may have the usual otorhinolaryngologic problems common to all children. When your child often suffers from infections of this type, please inform the transplant internist and your paediatrician for a referral to a specialist. Remember to call the physicians at the Centre before giving any new drug to your child. There are certain antibiotics that your child must not take since certain antibiotics may increase or decrease the concentration of Prograf®. When these antibiotics must be administered, your child’s concentrations of liver enzymes and of Prograf® must be checked frequently.