Abstract
BACKGROUND.: Adenovirus is commonly isolated from pediatric small bowel transplant recipients, but its clinical consequences remain poorly understood. METHODS.: The medical records of pediatric small bowel transplant recipients transplanted between January 2003 and December 2007 were reviewed. Thymoglobulin and basiliximab induction and tacrolimus-based immunosuppression were the standard of care. Logistic regression analysis was performed to determine risk factors for infection, descriptive analysis to determine adenovirus incidence, and Kaplan-Meier curve analysis to determine the timing of events after transplantation. RESULTS.: Ninety-eight patients were included; 38 were positive for adenovirus (incidence 23.5%), 23 for viral shedding, 23 for infections. Nine infections developed in the first month after transplantation and 8 during the following 5 months. The small bowel was involved in 19 cases. Younger age at transplantation was a risk factor for adenovirus infection (odds ratio=0.81, 95% confidence interval, 0.663-0.994, P=0.04). Treatment of rejection did not increase the risk of adenovirus infection. Cytomegalovirus D+/R-sero-status was a protective factor (odds ratio=0.26, 95% confidence interval, 0.06-1.089, P=0.04). CONCLUSIONS.: Adenovirus infections affected 24% of recipients and developed mostly during the first 6 months after transplantation. Small bowel is the most frequently involved site. Younger age at transplantation is a risk factor for adenovirus infection; whereas cytomegalovirus D+/R-sero-status seems to be protective.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 198-204 |
| Number of pages | 7 |
| Journal | Transplantation |
| Volume | 90 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jul 27 2010 |
| Externally published | Yes |
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Keywords
- Adenovirus
- Adenovirus disease
- Shedding
- Small bowel transplantation
ASJC Scopus subject areas
- Transplantation
Cite this
Adenovirus infections in pediatric small bowel transplant recipients. / Florescu, Diana F.; Islam, Km; Mercer, David F.; Grant, Wendy; Langnas, Alan N.; Freifeld, Alison G.; Sudan, Debra; Basappa, Rishika; Dimaio, Dominick; Kalil, Andre C.
In: Transplantation, Vol. 90, No. 2, 27.07.2010, p. 198-204.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adenovirus infections in pediatric small bowel transplant recipients
AU - Florescu, Diana F.
AU - Islam, Km
AU - Mercer, David F.
AU - Grant, Wendy
AU - Langnas, Alan N.
AU - Freifeld, Alison G.
AU - Sudan, Debra
AU - Basappa, Rishika
AU - Dimaio, Dominick
AU - Kalil, Andre C.
PY - 2010/7/27
Y1 - 2010/7/27
N2 - BACKGROUND.: Adenovirus is commonly isolated from pediatric small bowel transplant recipients, but its clinical consequences remain poorly understood. METHODS.: The medical records of pediatric small bowel transplant recipients transplanted between January 2003 and December 2007 were reviewed. Thymoglobulin and basiliximab induction and tacrolimus-based immunosuppression were the standard of care. Logistic regression analysis was performed to determine risk factors for infection, descriptive analysis to determine adenovirus incidence, and Kaplan-Meier curve analysis to determine the timing of events after transplantation. RESULTS.: Ninety-eight patients were included; 38 were positive for adenovirus (incidence 23.5%), 23 for viral shedding, 23 for infections. Nine infections developed in the first month after transplantation and 8 during the following 5 months. The small bowel was involved in 19 cases. Younger age at transplantation was a risk factor for adenovirus infection (odds ratio=0.81, 95% confidence interval, 0.663-0.994, P=0.04). Treatment of rejection did not increase the risk of adenovirus infection. Cytomegalovirus D+/R-sero-status was a protective factor (odds ratio=0.26, 95% confidence interval, 0.06-1.089, P=0.04). CONCLUSIONS.: Adenovirus infections affected 24% of recipients and developed mostly during the first 6 months after transplantation. Small bowel is the most frequently involved site. Younger age at transplantation is a risk factor for adenovirus infection; whereas cytomegalovirus D+/R-sero-status seems to be protective.
AB - BACKGROUND.: Adenovirus is commonly isolated from pediatric small bowel transplant recipients, but its clinical consequences remain poorly understood. METHODS.: The medical records of pediatric small bowel transplant recipients transplanted between January 2003 and December 2007 were reviewed. Thymoglobulin and basiliximab induction and tacrolimus-based immunosuppression were the standard of care. Logistic regression analysis was performed to determine risk factors for infection, descriptive analysis to determine adenovirus incidence, and Kaplan-Meier curve analysis to determine the timing of events after transplantation. RESULTS.: Ninety-eight patients were included; 38 were positive for adenovirus (incidence 23.5%), 23 for viral shedding, 23 for infections. Nine infections developed in the first month after transplantation and 8 during the following 5 months. The small bowel was involved in 19 cases. Younger age at transplantation was a risk factor for adenovirus infection (odds ratio=0.81, 95% confidence interval, 0.663-0.994, P=0.04). Treatment of rejection did not increase the risk of adenovirus infection. Cytomegalovirus D+/R-sero-status was a protective factor (odds ratio=0.26, 95% confidence interval, 0.06-1.089, P=0.04). CONCLUSIONS.: Adenovirus infections affected 24% of recipients and developed mostly during the first 6 months after transplantation. Small bowel is the most frequently involved site. Younger age at transplantation is a risk factor for adenovirus infection; whereas cytomegalovirus D+/R-sero-status seems to be protective.
KW - Adenovirus
KW - Adenovirus disease
KW - Shedding
KW - Small bowel transplantation
UR - http://www.scopus.com/inward/record.url?scp=77954897645&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954897645&partnerID=8YFLogxK
U2 - 10.1097/TP.0b013e3181e0de97
DO - 10.1097/TP.0b013e3181e0de97
M3 - Article
C2 - 20467354
AN - SCOPUS:77954897645
VL - 90
SP - 198
EP - 204
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 2
ER -