Introduction: In kidney transplant recipients, the incidence of adenovirus infection is 4.1%, usually occur in the first three months after transplantation. Patients may have viral syndrome, hematuria, and graft dysfunction. The aim of this study is to show the clinical characteristics of a case series. Methods: Retrospective case series. We include all kidney transplant recipients with a confirmed diagnosis of adenovirus infection by PCR (viruria/viremia) and/or graft biopsy (with typical adenovirus-associated histological lesions). Clinicopathologic characteristics, treatment and outcome are described. Results: 6 patients were included, 4M/2F, median age 31.3y. Five were confirmed by quantitative PCR and 1 by biopsy. The table shows baseline characteristics. All patients were treated with IVIG, and reduction of immunosuppression. One patient received ribavirin and one ganciclovir (CMV infection was suspected). Histopathological results revealed the presence of non-caseating granulomas and nephritis in 50 % of patients. 30% had increased interstitial fibrosis in subsequent biopsies. Two patients lost the graft by adenovirus and 1 nephrectomy was needed because persistent fever by extensive necrosis secondary to adenovirus infection (fever resolved after nephrectomy).

Conclusions: In all patients with viral syndrome plus hematuria and/or graft dysfunction, an adenovirus infection must be excluded by PCR and / or biopsy. Despite the reduction of the IS and IVIG infusion, 2 patients had graft loss. A high SCr at diagnosis is associated with graft loss.

CITATION INFORMATION: Simancas-Ruiz C, Marino-Vazquez L, Meraz-Muñoz A, Nuñez-Abreu A, Rivera-Marfil R, Uribe-Uribe N, Alberu J, Morales-Buenrostro L. Adenovirus Infection in Kidney Transplant Recipients: Report of a Case Series. Am J Transplant. 2016;16 (suppl 3).

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