*Purpose: This study aimed to characterize the management and impact of respiratory viral infections on pediatric kidney transplantation waitlisted candidates.

*Methods: An IRB-approved, anonymous REDCap survey was distributed to pediatric transplant nephrologist and infectious diseases practitioners from November 2021-January 2022 to members of the Pediatric Nephrology Research Consortium and the Pediatric Infectious Diseases Society via email. If multiple providers from the same center responded, questions related to center-wide practices were combined.

*Results: Sixty-six providers, 65 physicians and 1 nurse practitioner, responded to the survey from forty-eight different institutions (47 centers were in the United States). Providers estimated that respiratory viral infections were the most common cause of delays in transplant due to recipient infection. This fact has been highlighted during the pandemic with 46% of centers reporting they had delayed transplants for institutional reasons related to the pandemic and 38% had delayed transplants for active SARS-CoV-2 infection in a recipient, even before the omicron surge. Despite the impact of respiratory viral detection in waitlisted patients, over 80% of centers did not have a policy regarding delays for respiratory viral infections including SARS-CoV-2. Pre-transplant recipient screening for non-SARS-CoV-2 viral infections was not routine in 77% of centers but 45% of providers indicated they would delay a living donor transplant if they knew the recipient had an asymptomatic respiratory viral infection. For recipients with symptomatic respiratory viral infection, 95% and 87% of providers would delay transplant (living donor and deceased donor transplants respectively). Fifty-nine percent of providers indicated they would proceed with transplant after a waiting period ranging from one week to two months.

*Conclusions: Providers recognize that respiratory viral infections, not limited to SARS-CoV-2, are a common cause of pediatric kidney transplant delay. Most centers do not have defined approaches to screening and management of non-SARS CoV-2. Prospective studies and policies for screening and management of respiratory viral infections in waitlisted pediatric kidney transplant should be considered.

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