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

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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

Adenovirus infections in pediatric small bowel transplant recipients. / Florescu, Diana F; Islam, Monirul K.; Mercer, David F; Grant, Wendy; Langnas, Alan Norman; Freifeld, Alison Gail; Sudan, Debra; Basappa, Rishika; DiMaio, Dominick J; Kalil, Andre C.

In: Transplantation, Vol. 90, No. 2, 27.07.2010, p. 198-204.

Research output: Contribution to journalArticle

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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.",
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T1 - Adenovirus infections in pediatric small bowel transplant recipients

AU - Florescu, Diana F

AU - Islam, Monirul K.

AU - Mercer, David F

AU - Grant, Wendy

AU - Langnas, Alan Norman

AU - Freifeld, Alison Gail

AU - Sudan, Debra

AU - Basappa, Rishika

AU - DiMaio, Dominick J

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

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