title: Cytomegalovirus infection after intestinal transplantation in children.
abstract: Sixteen episodes of cytomegalovirus (CMV) disease occurred in 10 of 41 children undergoing intestinal transplantation from 1990 to 1995. Stratification of CMV disease by donor (D)/recipient (R) serological status was as follows: 3 of 8, D+/R-; 3 of 9, D+/R+; 4 of 9, D-/R+; and 0 of 15, D-/R-. Treatment resulted in resolution of CMV disease in 93.3% of episodes. No deaths attributable to CMV disease occurred in this series. CMV in D+/R- children resulted in more extensive and persistent disease. However, patient and graft survival rates were similar in the different D/R subgroups and between children with and without CMV disease. Cumulative dose of steroid boluses (relative risk [RR], 1.59; 95% confidence interval [CI], 1.14-2.21) and history of steroid recycles (RR, 2.72; 95% CI, 1.21-6.13) were associated with CMV disease. These results suggest that although CMV-associated morbidity in pediatric intestinal transplant recipients was substantial, it was not associated with an increased rate of mortality or graft loss, even among high-risk D+/R- patients.
authors.affiliation: University of Pittsburgh, Department of Surgery, Children's Hospital of Pittsburgh, Pennsylvania, USA.
authors.forename: J
authors.initials: J
authors.lastname: Bueno
authors.forename: M
authors.initials: M
authors.lastname: Green
authors.forename: S
authors.initials: S
authors.lastname: Kocoshis
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: K
authors.initials: K
authors.lastname: Abu-Elmagd
authors.forename: E
authors.initials: E
authors.lastname: Yunis
authors.forename: W
authors.initials: W
authors.lastname: Irish
authors.forename: S
authors.initials: S
authors.lastname: Todo
authors.forename: J
authors.initials: J
authors.lastname: Reyes
authors.forename: T E
authors.initials: TE
authors.lastname: Starzl
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016377:Organ Transplantation / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome