ComplicationEarly and Late Virological Monitoring of Cytomegalovirus, Epstein-Barr Virus, and Human Herpes Virus 6 Infections in Small Bowel/Multivisceral Transplant Recipients
Section snippets
Selection and Description of Participants
We enrolled 10 adult patients undergoing small bowel/multivisceral transplantation. There were 8 isolated small bowel and 2 multivisceral without liver transplants. The population comprised 7 men and 3 women aged between 22 and 51 years (average, 34).
Transplant recipients were categorized as early or late patients depending on the duration of the follow-up interval. Three of 10 patients were followed-up for 5 months posttransplantation from May to October 2008 (early period) and 7 patients were
Early Group (5 Months Posttransplantation Follow-Up)
All 3 patients studied during the first 5 months posttransplantation developed CMV symptomatic infections and were treated with gancyclovir. Their clinical and laboratory findings are summarized in Table 1.
Patient 1 developed a CMV infection (fever) at 112 days after a multivisceral transplantation without the liver. A high viral load was detected in the blood ranging from 11,400 to 152,300 copies/mL. No CMV positivity was detected in biopsy samples. In the same period a low EBV load was
Discussion
Intestinal transplant recipients require high levels of immunosuppression as a result of the large amount of lymphoid tissue in the graft, placing these patients at high risk for developing infections. The present study confirmed that despite prophylaxis CMV remains a major cause of organ disease, rejection, and recipient mortality in the first 6–8 months after transplantation. CMV infections occurred in all of the early group patients (3/3) with a mortality rate of 100% (3/3) due to sepsis in
Acknowledgments
We are grateful to Salustia Pop, Lorena Mezzofanti, Cristiana Grandi, and Antonella Maria Paglia for their excellent technical help. Anne Collins edited the English text.
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Supported by grants from the Programma di Ricerca Regione Università Emilia Romagna 2007-2009 Area 1a (project coordinator G. Torelli), and the Italia-USA project 28C5/3.