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Infectious enteritis after intestinal transplantation: incidence, timing, and outcome.
D Ziring1, R Tran, S Edelstein
1Dumont-UCLA Transplant Program, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Transplantation Proceedings
|March 31, 2004
Summary
Infectious enteritis frequently occurs after intestinal transplantation (IT), with viral agents being the most common cause. Prompt diagnosis and treatment lead to resolution in most cases, without adversely affecting patient or graft survival.
Area of Science:
- Gastroenterology
- Transplant Surgery
- Infectious Diseases
Background:
- Intestinal transplantation (IT) is a complex procedure with potential complications.
- Infectious enteritis is a significant concern following IT, impacting patient outcomes.
Purpose of the Study:
- To determine the incidence, timing, and outcomes of infectious enteritis post-intestinal transplantation.
- To identify common pathogens and their impact on graft and patient survival.
Main Methods:
- Retrospective review of all patients undergoing IT at a single institution from 1991 to 2003.
- Analysis of patient demographics, infection types, diagnosis timing, and treatment outcomes.
Main Results:
- 39% of 33 IT recipients developed infectious enteritis, with a median diagnosis at 76 days post-transplant.
- Viral agents (rotavirus, adenovirus) were the most frequent causes, accounting for two-thirds of infections.
- 94% of infections resolved with treatment; however, six rejection episodes occurred post-enteritis, with two graft losses linked to infection or misdiagnosis.
Conclusions:
- Infectious enteritis is a common complication after intestinal transplantation, predominantly caused by viral agents.
- Effective treatment and supportive care lead to high resolution rates.
- Distinguishing between graft rejection and infection can be challenging, necessitating careful histopathological evaluation.