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Herpes simplex virus hepatitis after solid organ transplantation in adults

Kusne, S and Schwartz, M and Breinig, MK and Dummer, JS and Lee, RE and Selby, R and Starzl, TE and Simmons, RL and Ho, M (1991) Herpes simplex virus hepatitis after solid organ transplantation in adults. Journal of Infectious Diseases, 163 (5). 1001 - 1007. ISSN 0022-1899

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Twelve patients developed herpes simplex (HSV) hepatitis a median of 18 days after solid organ transplantation. This is earlier than cytomegalovirus hepatitis, which usually occurs 30-40 days after transplantation. Eight recipients (67%) died, and in seven, the diagnosis was made at autopsy or <48 h before death. Clinical manifestations associated with mortality were hypotension, disseminated intravascular coagulation (DIC), metabolic acidosis, gastrointestinal bleeding, and bacteremia. Laboratory abnormalities at diagnosis associated with mortality were high creatinine, low platelet counts, prolonged partial thromboplastin time, and a high percentage of band forms on the blood smear. Disseminated HSV disease was noted in four of six patients who had an autopsy and included involvement of lungs in three and the gastrointestinal tract in three. Five recipients developed DIC and all died. Pathologically, HSV hepatitis has two forms, focal and diffuse. All three patients with diffuse liver pathology died. However, three of seven with focal liver pathology survived with antiviral therapy, which suggests that early diagnosis and treatment may be lifesaving. None of these patients had received prophylactic acyclovir. It is possible that acyclovir prophylaxis may be able to prevent this disease. © 1991 by The University of Chicago.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Kusne, S
Schwartz, M
Breinig, MK
Dummer, JS
Lee, RE
Selby, R
Starzl, TEtes11@pitt.eduTES11
Simmons, RL
Ho, Mmonto@pitt.eduMONTO
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1991
Date Type: Publication
Journal or Publication Title: Journal of Infectious Diseases
Volume: 163
Number: 5
Page Range: 1001 - 1007
DOI or Unique Handle: 10.1093/infdis/163.5.1001
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0022-1899
Other ID: uls-drl:31735062117845, Starzl CV No. 1233
Date Deposited: 08 Apr 2010 17:21
Last Modified: 04 Feb 2019 15:56


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