Viral enteritis in intestinal transplant recipients

Servais, A.M.; Keck, M.; Leick, M.; Mercer, D.F.; Langnas, A.N.; Grant, W.J.; Vargas, L.M.; Merani, S.; Florescu, D.F.

Transplant Infectious Disease An Official Journal of the Transplantation Society 22(2): E13248


ISSN/ISBN: 1399-3062
PMID: 31960531
DOI: 10.1111/tid.13248
Accession: 069730921

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Intestinal transplant recipients (ITR) are at high risk for infections due to the high level of immunosuppression required to prevent rejection. There are limited data regarding viral enteritis post-intestinal transplantation. We retrospectively reviewed ITR transplanted between January 2008 and December 2016. Descriptive statistics, including mean (standard deviation) and median (range), were performed. Sixty-one (43.9%) of the 139 transplanted patients had viral enteritis: 26% norovirus, 25% adenovirus, and 9% each rotavirus and sapovirus. The median age of pediatric patients was 1.6 years (0.4-16.9) and for adults 36.3 years (27.1-48.2). Fifty-seven (58%) of 99 pediatric ITR had viral enteritis compared to 4 (10%) of 40 adult ITR. Median time-to-clinical resolution of enteritis for all patients was 5 days (1-92). Standard of care therapies administered: anti-motility agents (10%), anti-emetics agents (14%), and intravenous fluids (42%). There was a higher incidence of viral enteritis in pediatric compared to adults ITR. The majority of viral enteritis episodes resolved within 1 week and were treated with supportive therapy.