Dr Henry HL Wu1, Dr FRANCESCA MORGANS-SLADER2, Dr OLA SULIMAN2, Dr RAJKUMAR CHINNADURAI2,3
1Kolling Institute, Royal North Shore Hospital & The University Of Sydney, Sydney, Australia, 2Department of Renal Medicine, Northern Care Alliance NHS Foundation Trust, Salford , United Kingdom , 3Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
Biography:
Dr Henry HL Wu is a Registrar at Royal North Shore Hospital, Doctoral Researcher at the Kolling Institute, University of Sydney and Visiting Research Fellow at the ARC Centre of Excellence for Nanoscale Biophotonics, UNSW. He was previously National Institute of Health Research Academic Clinical Fellow in Nephrology at the University of Manchester, UK from Aug 2019 to Dec 2021. Henry is associate editor for Nutrition & Health, review editor for Frontiers in Medicine, and editorial board member in BMC Nephrology and PloS One. He is also currently a member of the International Society of Nephrology CardioRenal Toolkit Workgroup.
Aim:
To conduct a systematic review of original publications reporting on human metapneumovirus (HMPV) infection in kidney transplant recipients.
Background:
There have been an emergence of HMPV cases worldwide since late 2024. Data detailing the disease course, outcomes, and management strategies for kidney transplant recipients with HMPV infection remain limited. Tailored guidance is indicated to optimize outcomes for kidney transplant recipients with HMPV infection.
Methods:
This study is registered with PROSPERO (CRD42025651994). A systematic search was performed on PubMed, EMBASE, MEDLINE and the Cochrane Library for original full-text articles published in English between Jan 2005 and Jan 2025 describing kidney transplant recipients age≥18 years with HMPV infection. Combination keywords used in the search process included: “HMPV” AND “Kidney Transplant”; “HMPV” AND “Renal Transplant”; “Human Metapneumovirus” AND “Renal Transplant”; “Human Metapneumovirus” AND “Kidney Transplant”; “HMPV” AND “Kidney Transplant” AND “Immunosuppression”; “Human Metapneumovirus” AND “Kidney Transplant” AND “Immunosuppression”.
Results:
There were 7 publications (3 case reports and 4 observational studies) published between Jan 2005 and Jan 2025. Vast variations in the severity and disease course of kidney transplant recipients presenting with HMPV was described, ranging from reports of a self-limiting disease course to indications for intensive care support. Mixed findings relating to graft dysfunction have been observed, varying between acute graft rejection to no adverse effects on graft function. A standardized management approach of HMPV in kidney transplant recipients is not yet available, with discrepancies in treatment strategies including the prescription of ribavirin, intravenous immunoglobulin and adjustment of post-transplant immunosuppression.
Conclusion:
HMPV infection can be a significant risk for the kidney transplant population. Further research is needed to determine an optimal management approach in this scenario.
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