Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Jan;43(1):63–67. doi: 10.1136/jcp.43.1.63

Viral and toxoplasma gondii infections in children after liver transplantation.

A Salt 1, G Sutehall 1, M Sargaison 1, C Woodward 1, N D Barnes 1, R Y Calne 1, T G Wreghitt 1
PMCID: PMC502227  PMID: 2155947

Abstract

The incidence and morbidity of viral and Toxoplasma gondii infections were studied in 40 children who underwent liver transplantation between December 1983 and February 1988. The incidence of primary and reactivated cytomegalovirus (CMV) infection was 19% and 47%, respectively; primary infection caused clinical disease in all five cases affected and was fatal in one. Primary Epstein-Barr virus (EBV) infection occurred in 10 (26%) recipients but caused only mild disease. No reactivated EBV infection was recorded and no lymphoproliferative disorders associated with EBV were found after a maximum of four years' follow up. Adenovirus infection occurred in seven (18%) patients; this was associated in one case with fatal pneumonia and fulminant hepatitis, but otherwise with only mild respiratory disease. Primary T gondii infection was detected in one patient who remained asymptomatic. Other viruses causing infection included herpes simplex, varicella zoster, and respiratory syncytial virus. Surveillance for these infections and the long term sequelae should be included in the follow up of all children who undergo transplantation.

Full text

PDF
63

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRADSTREET C. M., TAYLOR C. E. Technique of complementfixation test applicable to the diagnosis of virus diseases. Mon Bull Minist Health Public Health Lab Serv. 1962 May;21:96–104. [PubMed] [Google Scholar]
  2. Balfour A. H., Fleck D. G., Hughes H. P., Sharp D. Comparative study of three tests (dye test, indirect haemagglutination test, latex agglutination test) for the detection of antibodies to Toxoplasma gondii in human sera. J Clin Pathol. 1982 Feb;35(2):228–232. doi: 10.1136/jcp.35.2.228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Betts R. F. Cytomegalovirus infection in transplant patients. Prog Med Virol. 1982;28:44–64. [PubMed] [Google Scholar]
  4. Brandt C. D., Kim H. W., Vargosko A. J., Jeffries B. C., Arrobio J. O., Rindge B., Parrott R. H., Chanock R. M. Infections in 18,000 infants and children in a controlled study of respiratory tract disease. I. Adenovirus pathogenicity in relation to serologic type and illness syndrome. Am J Epidemiol. 1969 Dec;90(6):484–500. doi: 10.1093/oxfordjournals.aje.a121094. [DOI] [PubMed] [Google Scholar]
  5. Breinig M. K., Zitelli B., Starzl T. E., Ho M. Epstein-Barr virus, cytomegalovirus, and other viral infections in children after liver transplantation. J Infect Dis. 1987 Aug;156(2):273–279. doi: 10.1093/infdis/156.2.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dagan R., Schwartz R. H., Insel R. A., Menegus M. A. Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: possible therapeutic effect of human immune serum globulin containing specific neutralizing antibody. Pediatr Infect Dis. 1984 May-Jun;3(3):246–251. doi: 10.1097/00006454-198405000-00015. [DOI] [PubMed] [Google Scholar]
  7. Dummer J. S., Hardy A., Poorsattar A., Ho M. Early infections in kidney, heart, and liver transplant recipients on cyclosporine. Transplantation. 1983 Sep;36(3):259–267. doi: 10.1097/00007890-198309000-00007. [DOI] [PubMed] [Google Scholar]
  8. Fiala M., Payne J. E., Berne T. V., Moore T. C., Henle W., Montgomerie J. Z., Chatterjee S. N., Guze L. B. Epidemiology of cytomegalovirus infection after transplantation and immunosuppression. J Infect Dis. 1975 Oct;132(4):421–433. doi: 10.1093/infdis/132.4.421. [DOI] [PubMed] [Google Scholar]
  9. Gallo D., Walen K. H., Riggs J. L. Improved immunofluorescence antigens for detection of immunoglobulin M antibodies to Epstein-Barr viral capsid antigen and antibodies to Epstein-Barr virus nuclear antigen. J Clin Microbiol. 1982 Feb;15(2):243–248. doi: 10.1128/jcm.15.2.243-248.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gray J. J., Alvey B., Smith D. J., Wreghitt T. G. Evaluation of a commercial latex agglutination test for detecting antibodies to cytomegalovirus in organ donors and transplant recipients. J Virol Methods. 1987 May;16(1-2):13–19. doi: 10.1016/0166-0934(87)90026-7. [DOI] [PubMed] [Google Scholar]
  11. Hakim M., Wreghitt T. G., English T. A., Stovin P. G., Cory-Pearce R., Wallwork J. Significance of donor transmitted disease in cardiac transplantation. J Heart Transplant. 1985 May;4(3):302–306. [PubMed] [Google Scholar]
  12. Hanto D. W., Gajl-Peczalska K. J., Frizzera G., Arthur D. C., Balfour H. H., Jr, McClain K., Simmons R. L., Najarian J. S. Epstein-Barr virus (EBV) induced polyclonal and monoclonal B-cell lymphoproliferative diseases occurring after renal transplantation. Clinical, pathologic, and virologic findings and implications for therapy. Ann Surg. 1983 Sep;198(3):356–369. doi: 10.1097/00000658-198309000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Henle G., Henle W. Immunofluorescence in cells derived from Burkitt's lymphoma. J Bacteriol. 1966 Mar;91(3):1248–1256. doi: 10.1128/jb.91.3.1248-1256.1966. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Henle W., Henle G., Zajac B. A., Pearson G., Waubke R., Scriba M. Differential reactivity of human serums with early antigens induced by Epstein-Barr virus. Science. 1970 Jul 10;169(3941):188–190. doi: 10.1126/science.169.3941.188. [DOI] [PubMed] [Google Scholar]
  15. Hinuma Y., Konn M., Yamaguchi J., Wudarski D. J., Blakeslee J. R., Jr, Grace J. T., Jr Immunofluorescence and herpes-type virus particles in the P3HR-1 Burkitt lymphoma cell line. J Virol. 1967 Oct;1(5):1045–1051. doi: 10.1128/jvi.1.5.1045-1051.1967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ho M., Miller G., Atchison R. W., Breinig M. K., Dummer J. S., Andiman W., Starzl T. E., Eastman R., Griffith B. P., Hardesty R. L. Epstein-Barr virus infections and DNA hybridization studies in posttransplantation lymphoma and lymphoproliferative lesions: the role of primary infection. J Infect Dis. 1985 Nov;152(5):876–886. doi: 10.1093/infdis/152.5.876. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ho M., Suwansirikul S., Dowling J. N., Youngblood L. A., Armstrong J. A. The transplanted kidney as a source of cytomegalovirus infection. N Engl J Med. 1975 Nov 27;293(22):1109–1112. doi: 10.1056/NEJM197511272932201. [DOI] [PubMed] [Google Scholar]
  18. Ho M. Virus infections after transplantation in man. Brief review. Arch Virol. 1977;55(1-2):1–24. doi: 10.1007/BF01314475. [DOI] [PubMed] [Google Scholar]
  19. Kanno A., Ohori H., Nagatsuka Y., Sekino H., Tateda A., Goto Y., Ishida N. Seroepidemiological studies on a non-A, non-B hepatitis specific antigen/antibody system (SO-antigen/anti-SO). J Med Virol. 1986 Jan;18(1):1–10. doi: 10.1002/jmv.1890180102. [DOI] [PubMed] [Google Scholar]
  20. Koneru B., Jaffe R., Esquivel C. O., Kunz R., Todo S., Iwatsuki S., Starzl T. E. Adenoviral infections in pediatric liver transplant recipients. JAMA. 1987 Jul 24;258(4):489–492. doi: 10.1001/jama.1987.03400040087027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mejia G., Leiderman E., Builes M., Henao J., Arbelaez M., Arango J. L., Borrero J. Transmission of toxoplasmosis by renal transplant. Am J Kidney Dis. 1983 May;2(6):615–617. doi: 10.1016/s0272-6386(83)80041-9. [DOI] [PubMed] [Google Scholar]
  22. Nagington J., Gray J. Cyclosporin A immunosuppression, Epstein-Barr antibody, and lymphoma. Lancet. 1980 Mar 8;1(8167):536–537. doi: 10.1016/s0140-6736(80)92784-1. [DOI] [PubMed] [Google Scholar]
  23. Payne R. A., Isaac M., Francis J. M. Enzyme-linked immunosorbent assay (ELISA) using antibody class capture for the detection of antitoxoplasma IgM. J Clin Pathol. 1982 Aug;35(8):892–896. doi: 10.1136/jcp.35.8.892. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Peckham C. S., Johnson C., Ades A., Pearl K., Chin K. S. Early acquisition of cytomegalovirus infection. Arch Dis Child. 1987 Aug;62(8):780–785. doi: 10.1136/adc.62.8.780. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Peterson P. K., Balfour H. H., Jr, Marker S. C., Fryd D. S., Howard R. J., Simmons R. L. Cytomegalovirus disease in renal allograft recipients: a prospective study of the clinical features, risk factors and impact on renal transplantation. Medicine (Baltimore) 1980 Jul;59(4):283–300. [PubMed] [Google Scholar]
  26. Sairenji T., Sullivan J. L., Humphreys R. E. Complement-dependent, Epstein-Barr virus-neutralizing antibody appearing early in the sera of patients with infectious mononucleosis. J Infect Dis. 1984 May;149(5):763–768. doi: 10.1093/infdis/149.5.763. [DOI] [PubMed] [Google Scholar]
  27. Stalder H., Hierholzer J. C., Oxman M. N. New human adenovirus (candidate adenovirus type 35) causing fatal disseminated infection in a renal transplant recipient. J Clin Microbiol. 1977 Sep;6(3):257–265. doi: 10.1128/jcm.6.3.257-265.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Starzl T. E., Nalesnik M. A., Porter K. A., Ho M., Iwatsuki S., Griffith B. P., Rosenthal J. T., Hakala T. R., Shaw B. W., Jr, Hardesty R. L. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet. 1984 Mar 17;1(8377):583–587. doi: 10.1016/s0140-6736(84)90994-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Stern H. Isolation of cytomegalovirus and clinical manifestations of infection at different ages. Br Med J. 1968 Mar 16;1(5593):665–669. doi: 10.1136/bmj.1.5593.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wallenburg H. C., Dekker G. A., Makovitz J. W., Rotmans P. Low-dose aspirin prevents pregnancy-induced hypertension and pre-eclampsia in angiotensin-sensitive primigravidae. Lancet. 1986 Jan 4;1(8471):1–3. doi: 10.1016/s0140-6736(86)91891-x. [DOI] [PubMed] [Google Scholar]
  31. Wreghitt T. G., Gray J. J., Ward K. N., Salt A., Taylor D. L., Alp N. J., Tyms A. S. Disseminated adenovirus infection after liver transplantation and its possible treatment with ganciclovir. J Infect. 1989 Jul;19(1):88–89. doi: 10.1016/s0163-4453(89)95214-6. [DOI] [PubMed] [Google Scholar]
  32. Wreghitt T. G., Hakim M., Gray J. J., Kucia S., Cory-Pearce R., Wallwork J., English T. A. A detailed study of cytomegalovirus infections in the first 160 heart and heart/lung transplant recipients at Papworth Hospital, Cambridge, England. Transplant Proc. 1987 Feb;19(1 Pt 3):2495–2496. [PubMed] [Google Scholar]
  33. Zahradnik J. M., Spencer M. J., Porter D. D. Adenovirus infection in the immunocompromised patient. Am J Med. 1980 May;68(5):725–732. doi: 10.1016/0002-9343(80)90262-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES