Adenovirus infections in pediatric small bowel transplant recipients

Transplantation. 2010 Jul 27;90(2):198-204. doi: 10.1097/TP.0b013e3181e0de97.


Background: Adenovirus is commonly isolated from pediatric small bowel transplant recipients, but its clinical consequences remain poorly understood.

Methods: The medical records of pediatric small bowel transplant recipients transplanted between January 2003 and December 2007 were reviewed. Thymoglobulin and basiliximab induction and tacrolimus-based immunosuppression were the standard of care. Logistic regression analysis was performed to determine risk factors for infection, descriptive analysis to determine adenovirus incidence, and Kaplan-Meier curve analysis to determine the timing of events after transplantation.

Results: Ninety-eight patients were included; 38 were positive for adenovirus (incidence 23.5%), 23 for viral shedding, 23 for infections. Nine infections developed in the first month after transplantation and 8 during the following 5 months. The small bowel was involved in 19 cases. Younger age at transplantation was a risk factor for adenovirus infection (odds ratio=0.81, 95% confidence interval, 0.663-0.994, P=0.04). Treatment of rejection did not increase the risk of adenovirus infection. Cytomegalovirus D+/R- sero-status was a protective factor (odds ratio=0.26, 95% confidence interval, 0.06-1.089, P=0.04).

Conclusions: Adenovirus infections affected 24% of recipients and developed mostly during the first 6 months after transplantation. Small bowel is the most frequently involved site. Younger age at transplantation is a risk factor for adenovirus infection; whereas cytomegalovirus D+/R- sero-status seems to be protective.

MeSH terms

  • Adenoviridae Infections / drug therapy
  • Adenoviridae Infections / epidemiology
  • Adenoviridae Infections / etiology*
  • Adenoviridae Infections / mortality
  • Antibodies, Monoclonal / therapeutic use
  • Antilymphocyte Serum / therapeutic use
  • Antiviral Agents / therapeutic use
  • Basiliximab
  • Child
  • Ganciclovir / analogs & derivatives
  • Ganciclovir / therapeutic use
  • Humans
  • Immunosuppressive Agents / blood
  • Immunosuppressive Agents / therapeutic use
  • Intestine, Small / transplantation*
  • Liver Transplantation / adverse effects
  • Liver Transplantation / immunology
  • Postoperative Complications / virology
  • Recombinant Fusion Proteins / therapeutic use
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Tacrolimus / blood
  • Tacrolimus / therapeutic use
  • Valganciclovir
  • Virus Shedding


  • Antibodies, Monoclonal
  • Antilymphocyte Serum
  • Antiviral Agents
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab
  • Valganciclovir
  • Ganciclovir
  • Tacrolimus