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July 24, 1987, Vol 258, No. 4 >
ARTICLE | July 24, 1987

Adenoviral Infections in Pediatric Liver Transplant Recipients FREE

Baburao Koneru, MD; Ronald Jaffe, MB, BCh; Carlos O. Esquivel, MD, PhD; Rainer Kunz, MD; Satuoro Todo, MD; Shunzaburo Iwatsuki, MD; Thomas E. Starzl, MD, PhD
[+] Author Affiliations

Reprint requests to Department of Surgery, 4 W Falk Clinic, 3601 Fifth Ave, Pittsburgh, PA 15213 (Dr Koneru).


JAMA. 1987;258(4):489-492. doi:10.1001/jama.1987.03400040087027
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References

Over a 51/2-year period, 22 of 262 children receiving liver transplants developed adenoviral infections. Five had adenoviral hepatitis in the allograft, caused by serotype 5. All five were treated for rejection, either just before or at the time of infection. Liver biopsy specimens had characteristic histological appearance, and diagnosis of adenoviral infection was confirmed with monoclonal antiadenoviral antibodies, electron microscopy, and by culture of liver tissue. In the remaining 17 patients, adenovirus was isolated from urine, stool, throat secretions, and/or blood samples, but none had any detectable visceral infection. Serotypes 1 and 2 predominated, similar to children not receiving transplants during the same time period. Three of the patients with hepatitis are alive and well; two died of liver failure. Adenoviral hepatitis did not recur in the second allograft of a patient who underwent retransplantation for combined rejection and adenoviral hepatitis, and appears, therefore, not to be a contraindication to retransplantation when liver failure ensues.

(JAMA 1987;258:489-492)

REFERENCES

1 +
Rowe WP, Huebner RJ, Gilmore LK, et al:  Isolation of a cytopathogenic agent from human adenoids undergoing spontaneous degeneration in tissue culture . Proc Soc Exp Biol Med 1953;;84: 570-573.
2 +
Brandt CD, Kim HW, Vargosko AJ, et al:  Infections in 18 000 infants and children in a controlled study of respiratory tract disease: I. Adenovirus pathogenicity in relation to serological type and illness syndrome . Am J Epidemiol 1969;;90: 484-500.
3 +
Chanock RM:  Impact of adenoviruses in human disease . Prev Med 1974;;3:466-472.
4 +
DeJong JC, Wigand R, Kidd AH, et al:  Candidate adenoviruses 40 and 41, fastidious adenoviruses from human infant stool . J Med Virol 1983;;11:215-231.
5 +
Aterman K, Embil J, Easterbrook KB, et al:  Liver necrosis: Adenovirus type 2 and thymic dysplasia . Virchows Arch A 1973;;360:155-171.
6 +
Wigger JH, Blanc WA:  Fatal hepatic and bronchial necrosis in adenovirus infection with thymic alymphoplasia . N Engl J Med 1966;;275:870-874.
7 +
Zhradnik JM, Spencer MJ, Porter DD:  Adenovirus infection in the immunocompromised patient . Am J Med 1980;;68:725-732.
8 +
Fiala M, Payne JE, Berne TV, et al:  Role of adenovirus type 11 in hemorrhagic cystitis secondary to immunosuppression . J Urol 1974;;112:595-597.
9 +
Keller EW, Rubin RH, Black PH, et al:  Isolation of adenovirus type 34 from a renal transplant recipient with interstitial pneumonia . Transplantation 1977;;23:188-191.
10 +
Shields AF, Hackman RC, Fife KH, et al:  Adenovirus infections in patients undergoing bone marrow transplantation . N Engl J Med 1985;;312: 529-533.
11 +
Purtillo DT, White R, Filipovich A, et al:  Fulminant liver failure induced by adenovirus after bone marrow transplantation . N Engl J Med 1985;; 312:1707-1708.
12 +
Stalder H, Hierholzer JC, Oxman MN:  New human adenovirus (candidate adenovirus type 35) causing fatal disseminated infection in a renal transplant recipient . J Clin Microbiol 1977;;6:257-265, 366-376.
13 +
Rodriguez FH, Liuzza GE, Gohd RH:  Disseminated adenovirus serotype 31 infection in an immunocompromised host . Am J Clin Pathol 1984;;82: 615-618.
14 +
South MA, Dolen J, Beach DK, et al:  Fatal adenovirus hepatic necrosis in severe combined immunodeficiency . Pediatr Infect Dis 1982;;6:416-419.
15 +
Perreira HG, Allison AC, Niven JSF:  Fatal infection of newborn hamsters by an adenovirus of human origin . Nature 1962;;196:244-245.
16 +
Postlethwaite R:  Liver damage induced in mice by human adenovirus type 5 . Scott Med J 1973;; 18:131.
17 +
Fox JP, Hall CE, Cooney MK:  The Seattle virus watch: VII. Observations of adenovirus infections . Am J Epidemiol 1977;;105:362-386.
18 +
Horwitz MS, Valderrama G, Hatcher V, et al:  Characterization of adenovirus isolates from AIDS patients . Ann NY Acad Sci 1985;;437:161-174.
19 +
Huebner RJ, Rowe WP, Panott TG, et al:  Adenoidal-pharyngeal-conjunctival agents: A newly recognized group of common viruses of the respiratory system . N Engl J Med 1954;;251:1077-1086.
20 +
Andiman WA, Miller G:  Persistent infection with adenovirus types 5 and 6 in lymphoid cells from humans and woolly monkeys . J Infect Dis 1982;;145:83-88.
21 +
Faucon N, Desgranges C:  Persistence of human adenovirus 5 in human cord blood lymphoblastoid cell lines transformed by Epstein-Barr virus . Infect Immun 1980;;29:1180-1184.
22 +
Hirsch MS:  Immune activation of endogenous viruses , in, Crowell R, Friedman H, Prier J (eds): Tumor Virus Infections and Immunity . Baltimore, University Park Press, 1976;, p 175.
23 +
Shields AF, Hackman RC, Fife KH, et al:  Fulminant liver failure induced by adrenal virus after bone marrow transplantation, letter to the editor . N Engl J Med 1985;;312:1708.
24 +
Lopez C, Simmons RL, Mauer SM, et al:  Association of renal allograft rejection with virus infections . Am J Med 1974;;56:280-289.
25 +
Fadden H, Gallagher M:  Disseminated infection due to adenovirus type 4 . Clin Pediatr 1980;;19: 427-429.
26 +
Varsano I, Schonfeld TM, Matoth Y, et al:  Severe disseminated adenovirus infection successfully treated with a thymic humoral factor THF . Acta Paediatr Scand 1977;;66:329-331.
27 +
Dagan R, Schwartz RH, Insel RA, et al:  Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: Possible therapeutic effect of human serum globulin containing a specific neutralizing antibody . Pediatr Infect Dis 1984;;3:246-251.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Rowe WP, Huebner RJ, Gilmore LK, et al:  Isolation of a cytopathogenic agent from human adenoids undergoing spontaneous degeneration in tissue culture . Proc Soc Exp Biol Med 1953;;84: 570-573.
2 +
Brandt CD, Kim HW, Vargosko AJ, et al:  Infections in 18 000 infants and children in a controlled study of respiratory tract disease: I. Adenovirus pathogenicity in relation to serological type and illness syndrome . Am J Epidemiol 1969;;90: 484-500.
3 +
Chanock RM:  Impact of adenoviruses in human disease . Prev Med 1974;;3:466-472.
4 +
DeJong JC, Wigand R, Kidd AH, et al:  Candidate adenoviruses 40 and 41, fastidious adenoviruses from human infant stool . J Med Virol 1983;;11:215-231.
5 +
Aterman K, Embil J, Easterbrook KB, et al:  Liver necrosis: Adenovirus type 2 and thymic dysplasia . Virchows Arch A 1973;;360:155-171.
6 +
Wigger JH, Blanc WA:  Fatal hepatic and bronchial necrosis in adenovirus infection with thymic alymphoplasia . N Engl J Med 1966;;275:870-874.
7 +
Zhradnik JM, Spencer MJ, Porter DD:  Adenovirus infection in the immunocompromised patient . Am J Med 1980;;68:725-732.
8 +
Fiala M, Payne JE, Berne TV, et al:  Role of adenovirus type 11 in hemorrhagic cystitis secondary to immunosuppression . J Urol 1974;;112:595-597.
9 +
Keller EW, Rubin RH, Black PH, et al:  Isolation of adenovirus type 34 from a renal transplant recipient with interstitial pneumonia . Transplantation 1977;;23:188-191.
10 +
Shields AF, Hackman RC, Fife KH, et al:  Adenovirus infections in patients undergoing bone marrow transplantation . N Engl J Med 1985;;312: 529-533.
11 +
Purtillo DT, White R, Filipovich A, et al:  Fulminant liver failure induced by adenovirus after bone marrow transplantation . N Engl J Med 1985;; 312:1707-1708.
12 +
Stalder H, Hierholzer JC, Oxman MN:  New human adenovirus (candidate adenovirus type 35) causing fatal disseminated infection in a renal transplant recipient . J Clin Microbiol 1977;;6:257-265, 366-376.
13 +
Rodriguez FH, Liuzza GE, Gohd RH:  Disseminated adenovirus serotype 31 infection in an immunocompromised host . Am J Clin Pathol 1984;;82: 615-618.
14 +
South MA, Dolen J, Beach DK, et al:  Fatal adenovirus hepatic necrosis in severe combined immunodeficiency . Pediatr Infect Dis 1982;;6:416-419.
15 +
Perreira HG, Allison AC, Niven JSF:  Fatal infection of newborn hamsters by an adenovirus of human origin . Nature 1962;;196:244-245.
16 +
Postlethwaite R:  Liver damage induced in mice by human adenovirus type 5 . Scott Med J 1973;; 18:131.
17 +
Fox JP, Hall CE, Cooney MK:  The Seattle virus watch: VII. Observations of adenovirus infections . Am J Epidemiol 1977;;105:362-386.
18 +
Horwitz MS, Valderrama G, Hatcher V, et al:  Characterization of adenovirus isolates from AIDS patients . Ann NY Acad Sci 1985;;437:161-174.
19 +
Huebner RJ, Rowe WP, Panott TG, et al:  Adenoidal-pharyngeal-conjunctival agents: A newly recognized group of common viruses of the respiratory system . N Engl J Med 1954;;251:1077-1086.
20 +
Andiman WA, Miller G:  Persistent infection with adenovirus types 5 and 6 in lymphoid cells from humans and woolly monkeys . J Infect Dis 1982;;145:83-88.
21 +
Faucon N, Desgranges C:  Persistence of human adenovirus 5 in human cord blood lymphoblastoid cell lines transformed by Epstein-Barr virus . Infect Immun 1980;;29:1180-1184.
22 +
Hirsch MS:  Immune activation of endogenous viruses , in, Crowell R, Friedman H, Prier J (eds): Tumor Virus Infections and Immunity . Baltimore, University Park Press, 1976;, p 175.
23 +
Shields AF, Hackman RC, Fife KH, et al:  Fulminant liver failure induced by adrenal virus after bone marrow transplantation, letter to the editor . N Engl J Med 1985;;312:1708.
24 +
Lopez C, Simmons RL, Mauer SM, et al:  Association of renal allograft rejection with virus infections . Am J Med 1974;;56:280-289.
25 +
Fadden H, Gallagher M:  Disseminated infection due to adenovirus type 4 . Clin Pediatr 1980;;19: 427-429.
26 +
Varsano I, Schonfeld TM, Matoth Y, et al:  Severe disseminated adenovirus infection successfully treated with a thymic humoral factor THF . Acta Paediatr Scand 1977;;66:329-331.
27 +
Dagan R, Schwartz RH, Insel RA, et al:  Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: Possible therapeutic effect of human serum globulin containing a specific neutralizing antibody . Pediatr Infect Dis 1984;;3:246-251.

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