Publication: Adenovirus disease after kidney transplantation: Course of infection and outcome in relation to blood viral load and immune recovery
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Issued Date
2011-06-01
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ISSN
16006143
16006135
16006135
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2-s2.0-79958863518
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Transplantation. Vol.11, No.6 (2011), 1308-1314
Suggested Citation
S. P. Watcharananan, R. Avery, A. Ingsathit, K. Malathum, W. Chantratita, V. Mavichak, P. Chalermsanyakorn, S. Jirasiritham, V. Sumethkul Adenovirus disease after kidney transplantation: Course of infection and outcome in relation to blood viral load and immune recovery. American Journal of Transplantation. Vol.11, No.6 (2011), 1308-1314. doi:10.1111/j.1600-6143.2011.03479.x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12489
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Title
Adenovirus disease after kidney transplantation: Course of infection and outcome in relation to blood viral load and immune recovery
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Abstract
Information on the clinical spectrum and management of adenovirus infection after kidney transplantation is limited. From April 2007 to April 2010, 17 kidney transplant recipients were diagnosed with adenovirus disease. The median time to infection was 5 (range, 2-300) weeks after transplantation. Of the 17 patients, 13 (76.5%) presented early, within 3 months posttransplant, and four (23.5%) presented late, more than 3 months after transplant. Besides urinary tract, involvement of other organs was common (63.6%) among patients with adenovirus viremia. Despite reduction of immunosuppression, six patients subsequently had a rise in the level of blood viral load, mostly within a week after diagnosis. However, only three (27.3%) patients with early infection developed disease progression. Compared to the late infection group, patients with early infection had significantly lower absolute lymphocyte counts at week 1 (p = 0.01) and 3 (p = 0.002) after diagnosis. Four patients received intravenous cidofovir. At 6-month follow-up, 10 (90.9%) patients had reversible graft dysfunction. Only one (5.7%) died from bacterial sepsis. Adenovirus disease is a significant complication following kidney transplantation. Early case recognition with reduction of immunosuppression is critical. Serial blood adenovirus viral loads and assessment of lymphocyte recovery are also useful in monitoring the course of infection. This study reports on the characteristics and outcome of adenovirus disease among kidney recipients and shows that prompt reduction of immunosuppression and close monitoring of blood viral load are useful, particularly in high-risk patients with infection early post-transplantation. © 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.