Abstract: SA-PO1210
Probiotic Use in Pediatric Kidney Transplant Recipients: A Single-Center Retrospective Study
Session Information
- Transplantation: Clinical - Complications, Pediatrics, and Multi-Organ Considerations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Akhoury, Ambika, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background
Pediatric kidney transplant recipients face significant gastrointestinal morbidity, recurrent infections, and dysbiosis related to immunosuppressive therapy and antibiotic use. Probiotics have been proposed as a potential adjunctive intervention, yet evidence regarding their safety and clinical utility in immunocompromised pediatric transplant patients remains limited. We describe our center's experience with probiotic use in pediatric kidney transplant recipients.
Methods
We conducted a single-center retrospective cohort study of pediatric kidney transplant recipients who received probiotics post-transplant. Transplant characteristics, indications for probiotic initiation, probiotic type, and infectious complications were extracted from the medical record. The Kaplan-Meier method was used to estimate the median duration of probiotic use, measured from the transplant date or probiotic start date, whichever was later.
Results
In our cohort of 36 pediatric kidney transplant recipients, 55.6% were male. Most patients (60%) received a living donor transplant, and 56% had congenital anomalies of the kidney and urinary tract as the underlying cause of kidney failure. Common indications for probiotic initiation included antibiotic-associated diarrhea (34.3%), promotion of gut health (28.6%), and other GI symptoms (31.4%). Prior to probiotic initiation, 45.7% of patients had recurrent UTIs (median 2/year) and 25.7% had a history of Clostridioides difficile infection, with probiotics used as adjunctive treatment in 5.7% of those cases. The median duration of posttransplant probiotic use was 4.6 [ IQR: 0.4, 8.5] years, and Lactobacillus rhamnosus GG was used most commonly (49%). Adherence was reported in 83.3% of patients, and 55.9% ultimately discontinued probiotics. Eleven recipients (31.4%) had documented sepsis after probiotic initiation with organisms including candida, enterococcus, citrobacter, Staph aureus, moraxella, and polymicrobial infection. No case of lactobacillus infection was identified. We found no adverse events directly linked to probiotic use.
Conclusion
Probiotics use in our cohort of pediatric kidney transplant recipients was safe. Additional studies are required to determine the efficacy of probiotics in this population.