[Characteristics of viral gastroenteritis in solid organ transplant patients]

Gastrointestinal disorders are a common complication following solid organ transplantation, but they also pose a real diagnostic challenge. There are many possible causes, ranging from immunosuppressive treatment toxicity to bacterial, parasitic, and viral infections. The use of syndromic molecular tests in microbiology has highlighted the important role played by enteric viruses, particularly norovirus, in the onset of diarrhea in transplant patients. These viruses, which are mostly benign in immunocompetent individuals, can cause severe and, above all, chronic infections responsible for significant morbidity and mortality and graft dysfunction. This review describes the characteristics of viral gastroenteritis in solid organ transplant patients, its epidemiology, pathophysiology, and clinical presentation. Finally, while the treatment of viral diarrhea is still based on symptomatic measures and the reduction of immunosuppression, it reviews the new specific antiviral therapies currently being evaluated. Overall, a better understanding of viral gastroenteritis in solid organ transplant patients is essential, as it is a major issue and diagnosis is crucial for appropriate management, at a time when the number of individuals with a functional transplant is increasing every year in France and worldwide.