Adenovirus Infection in Pediatric Liver Transplant Recipients: A Single Center Experience
1Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 2Department of Surgery, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 3Department of Pharmacy, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 4Outcomes and Impact Service, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 5Department of Pediatrics, Infectious Diseases, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 6Baylor College of Medicine/ Texas Children's Hospital, Houston, TX, 7Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine/ Texas Children's Hospital, Houston, TX
Meeting: 2020 American Transplant Congress
Abstract number: D-149
Keywords: Adenoviruses, Immunosuppression, Liver transplantation
Session Information
Date: Saturday, May 30, 2020
Session Name: Poster Session D: Liver: Pediatrics
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Immunosuppression predisposes children to primary viral or latent infections after liver transplantation (LT). The impact of adenovirus infections on morbidity and mortality remains largely undefined in children post-LT. The purpose of this study is to describe the incidence, manifestations and outcomes of adenovirus infections following LT at our institution.
*Methods: Electronic medical records of children who underwent LT between January 2013 and December 2018 were retrospectively reviewed. We recorded baseline demographics and captured data on PCR testing for adenovirus from various sources (nasal wash, tracheal aspirate, stool, tissue and plasma), Cidofovir use, and mortality. Infection was defined as presence of adenovirus in serum, stool, or nasal wash or aspirate.
*Results: We performed 199 pediatric LTs during the study period and 54 (27.1%) unique patients developed adenovirus infections. Of these patients, there were 62 separate adenovirus infection types, 10% of which occurred within thirty days of LT, a period of intense immunosuppression. Viremia was identified in 32% of adenovirus-positive cases, but only 16% of these were treated with Cidofovir. Common adenovirus infection manifestations included pulmonary complications, gastroenteritis, hepatitis and fever. Mortality approached 5% in all adenovirus positive patients during the study time period.(Table 1).
| Year | LT, N | Adenovirus positive N (%) | <30 days N (%) | <1 year N (%) | Viremia N (%) | Cidofovir Treatment N (%) | Mortality N (%) |
| 2013 | 42 | 16 (38) | 6 (14.3) | 11 (26) | 3 (18.7) | 2 (12.5) | 1 (6.25) |
| 2014 | 32 | 12 (37) | 4 (12.5) | 8 (25) | 5 (41.7) | 4 (33.4) | 0 |
| 2015 | 30 | 15 (50) | 5 (16.7) | 14 (26,7) | 4 (26.7) | 3 (20) | 2 (13.3) |
| 2016 | 19 | 5 (26) | 0 | 2 (10.5) | 3 (60) | 0 | 0 |
| 2017 | 40 | 9 (22) | 3 (7.5) | 8 (20) | 1 (11) | 1 (11) | 0 |
| 2018 | 39 | 5 (13) | 3 (7.7) | 5 (12.8) | 4 (60) | 0 | 0 |
| Total | 199 | 62 (31) | 21 (10.5) | 48 (24) | 20 (32) | 10 (16) | 3 (4.8) |
*Conclusions: Adenovirus infection is common in children post-LT and carries a risk of mortality in the early post-transplant period. Further studies are needed to identify optimal timing for screening, treatment outcomes/strategies and impact of viral co-infection.
To cite this abstract in AMA style:
Hassan S, Mysore KR, Faraone ME, Cerminara D, Hosek K, Moulton E, Bocchini C, Sigereddi R, Ackah R, Muñoz F, Rana A, Goss J, Leung DH, Galvan T. Adenovirus Infection in Pediatric Liver Transplant Recipients: A Single Center Experience [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/adenovirus-infection-in-pediatric-liver-transplant-recipients-a-single-center-experience/. Accessed March 8, 2021.« Back to 2020 American Transplant Congress