Fatal disseminated adenoviral infection in an adult heart transplant patient

Department of Pathology, University of Texas-Houston, Houston, Texas, USA.
The Journal of Heart and Lung Transplantation (Impact Factor: 6.65). 11/2004; 23(10):1209-12. DOI: 10.1016/j.healun.2003.08.026
Source: PubMed


In heart transplant recipients, infection is one of the leading causes of morbidity and mortality. In adult heart transplant patients, cytomegalovirus is the most frequently encountered viral pathogen. Conversely, disseminated adenoviral infection is observed mainly in children, where it is predictive of allograft rejection and coronary vasculopathy. The literature contains only a few reports of adenoviral infections in adult heart transplant recipients. Limited information is available concerning the diagnosis and epidemiology of such infections and their relationship to organ rejection, heart failure and overall outcomes in these patients. To promote an awareness of this potentially lethal complication, we present a case of fatal disseminated adenoviral infection in an adult heart transplant recipient.

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    • "Cardiology Research and Practice severe systemic acute infection, potentially of viral origin leading to graft loss which has been increasingly reported [12]. An infiltrative myocardial disease of the recipient could be suspected such as amyloidosis or lymphoproliferative disease affecting the heart. "
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    ABSTRACT: In the current era of immunosuppressive medications there is increased observed incidence of graft dysfunction in the absence of known histological criteria of rejection after heart transplantation. A noninvasive molecular expression diagnostic test was developed and validated to rule out histological acute cellular rejection. In this paper we present for the first time, longitudinal pattern of changes in this novel diagnostic test score along with QTc-interval in a patient who was admitted with unexplained graft dysfunction. Patient presented with graft failure with negative findings on all known criteria of rejection including acute cellular rejection, antibody mediated rejection and cardiac allograft vasculopathy. The molecular expression test score showed gradual increase and QTc-interval showed gradual prolongation with the gradual decline in graft function. This paper exemplifies that in patients presenting with unexplained graft dysfunction, GEP test score and QTc-interval correlate with the changes in the graft function.
    Cardiology Research and Practice 06/2010; 2010(1):230810. DOI:10.4061/2010/230810
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    ABSTRACT: Adenoviruses are increasingly recognized as contributors to morbidity and mortality among stem cell and solid-organ transplant recipients. Clinical presentations range from asymptomatic viremia to respiratory and gastrointestinal disease, hemorrhagic cystitis, and severe disseminated illness. The limited clinical data available support the use of cidofovir for many of these illnesses. Prospective studies are needed to better understand the pathogenesis of and therapeutic options for adenoviral infections in this patient population.
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