Adenovirus infections in pediatric small bowel transplant recipients

Diana F. Florescu, Km Islam, David F. Mercer, Wendy Grant, Alan N. Langnas, Alison G. Freifeld, Debra Sudan, Rishika Basappa, Dominick Dimaio, Andre C. Kalil

Research output: Contribution to journalArticle

40 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)198-204
Number of pages7
JournalTransplantation
Volume90
Issue number2
DOIs
StatePublished - Jul 27 2010
Externally publishedYes

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Adenoviridae Infections
Transplantation
Pediatrics
Adenoviridae
Cytomegalovirus
Infection
Odds Ratio
Confidence Intervals
Virus Shedding
Incidence
Kaplan-Meier Estimate
Tacrolimus
Standard of Care
Immunosuppression
Medical Records
Logistic Models
Regression Analysis
Transplant Recipients

Keywords

  • Adenovirus
  • Adenovirus disease
  • Shedding
  • Small bowel transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Florescu, D. F., Islam, K., Mercer, D. F., Grant, W., Langnas, A. N., Freifeld, A. G., ... Kalil, A. C. (2010). Adenovirus infections in pediatric small bowel transplant recipients. Transplantation, 90(2), 198-204. https://doi.org/10.1097/TP.0b013e3181e0de97

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 journalArticle

Florescu, DF, Islam, K, Mercer, DF, Grant, W, Langnas, AN, Freifeld, AG, Sudan, D, Basappa, R, Dimaio, D & Kalil, AC 2010, 'Adenovirus infections in pediatric small bowel transplant recipients', Transplantation, vol. 90, no. 2, pp. 198-204. https://doi.org/10.1097/TP.0b013e3181e0de97
Florescu DF, Islam K, Mercer DF, Grant W, Langnas AN, Freifeld AG et al. Adenovirus infections in pediatric small bowel transplant recipients. Transplantation. 2010 Jul 27;90(2):198-204. https://doi.org/10.1097/TP.0b013e3181e0de97
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. / Adenovirus infections in pediatric small bowel transplant recipients. In: Transplantation. 2010 ; Vol. 90, No. 2. pp. 198-204.
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AU - Freifeld, Alison G.

AU - Sudan, Debra

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AU - Kalil, Andre C.

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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.

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