Clinical characteristics and outcomes of adenovirus infection of the urinary tract after renal transplantation

Nanmoku, Koji; Ishikawa, Nobuo; Kurosawa, Atsushi; Shimizu, Tatsuya; Kimura, Tomonori; Miki, Atsushi; Sakuma, Yoshiki; Yamada, Takashi

doi:10.1111/tid.12519

Cited by 24 publications

(24 citation statements)

References 18 publications

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“…[121][122][123][124][125][126] Although adenoviral infection in HSCT is more likely to cause severe disease than in SOT, there are reports of graft infection and rejection with adenovirus in essentially all SOT populations. 123,127,128 Infection in lung recipients is common (up to 22% in 1 series) and there are multiple reports of severe infection, including graft loss, progression to BOS, and death. 125,[129][130][131][132] Infection in HSCT recipients can be severe and associated with significant mortality.…”

Section: Adenovirusmentioning

confidence: 99%

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Paulsen

Danziger‐Isakov

2017

Clinics in Chest Medicine

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Respiratory viruses are common in solid organ and hematopoietic stem cell transplant recipients and a recognized cause of significant morbidity and mortality. Epidemiology, risk factors, and attributable mortality in both populations are reviewed. In addition, virus-specific prevention and treatment options, including emerging investigational therapies, are discussed for respiratory syncytial virus, influenza, adenovirus, parainfluenza, and other respiratory viruses.

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Section: Adenovirusmentioning

confidence: 99%

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Paulsen

Danziger‐Isakov

2017

Clinics in Chest Medicine

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“…9 Additional information is available from five renal transplant patients with ADV urinary tract infections treated with ganciclovir 5 mg/kg/ day for 5-7 days. 21 No adverse events were reported. The authors concluded that ganciclovir may be effective against ADV viremia.…”

Section: Discussionmentioning

confidence: 97%

“…Ganciclovir activity was first described in vitro from a fatal case of disseminated ADV in a pediatric liver transplant patient . Additional information is available from five renal transplant patients with ADV urinary tract infections treated with ganciclovir 5 mg/kg/day for 5–7 days . No adverse events were reported.…”

Section: Discussionmentioning

confidence: 99%

Adjunctive Use of Cidofovir and Intravenous Immunoglobulin to Treat Invasive Adenoviral Disease in Solid Organ Transplant Recipients

2018

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Background Infections with adenoviruses (ADVs) can result in considerable mortality and morbidity in solid organ transplant (SOT) recipients. Standard therapy for ADV infections in transplant recipients is not established. At our institution, intravenous cidofovir and immunoglobulin have been used to treat disseminated or invasive ADV in SOT and hematopoietic stem cell transplant recipients. Methods A retrospective case series of SOT recipients treated with cidofovir and intravenous immunoglobulin was performed. Results Five SOT recipients (four renal and one heart transplant) with adenovirus infection were treated successfully with cidofovir and immunoglobulin. Cidofovir was discontinued after the first negative ADV viral load and resolution of clinical symptoms, given the concern for nephrotoxicity in renal transplant recipients. Renal tubular acidosis type 2 and iritis were observed in two patients receiving therapy. Conclusion Symptom resolution and a single negative ADV viral load may be indicators for cidofovir discontinuation.

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“…It has also been described that the majority of patients presenting with haemorrhagic cystitis have an associated acute graft dysfunction, and in the large majority of patients, renal function returns to baseline after resolution of ADV infection . In the series reported by Watcharananan et al ., 11 of 17 patients (64.7%) showed an initial rise in serum creatinine, and kidney allograft pathology was described in three cases; tubulointerstitial nephritis (ADV nephritis), acute tubular necrosis, and acute rejection, suggesting that the incidence of concurrent ADV nephritis is not necessarily high among patients with haemorrhagic cystitis.…”

Section: Adv Infection In Kidney Transplant Patientsmentioning

confidence: 99%

Viral infections directly involved in kidney allograft function

Masutani

2018

Nephrology

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Modern immunosuppressive therapy has dramatically reduced the incidence of acute rejection and improved graft survival in kidney transplant patients. However, infectious complications remain an important issue. Amongst the various pathogens, viruses such as adenovirus and polyomavirus BK can directly cause acute or chronic graft dysfunction. Adenovirus mainly causes haemorrhagic cystitis and tubulointerstitial nephritis in kidney transplant patients. While patients show apparent clinical symptoms such as fever, dysuria, gross haematuria, frequency and urgency of urination, and most patients show acute graft dysfunction, these symptoms and graft dysfunction are reversible. Polyomavirus BK infection, however, is asymptomatic but graft outcome is poor if the patient develops tissue-invasive nephropathy confirmed by graft biopsy. Recently, an attempt to create a pathological classification for predicting the clinical course has been made by the Banff Working Group on Polyomavirus Nephropathy. With regards to treatment, the basic strategy is a reduction of calcineurin inhibitor and/or antimetabolites, and the effectiveness of several adjunct treatments has been investigated in several clinical trials. There are other unresolved issues, such as the diagnosis of subsequent acute rejection, the definition of remission, methods of resuming immunosuppression and long-term follow-up. Most of all, development of effective vaccines and novel drug discovery are necessary to prevent the development and progression of BKV-associated nephropathy.

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Clinical characteristics and outcomes of adenovirus infection of the urinary tract after renal transplantation

Cited by 24 publications

References 18 publications

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Adjunctive Use of Cidofovir and Intravenous Immunoglobulin to Treat Invasive Adenoviral Disease in Solid Organ Transplant Recipients

Viral infections directly involved in kidney allograft function

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