ADENOVIRUS HEPATITIS IN THE ADULT ALLOGRAFT LIVER

Background. Adenovirus hepatitis in the allograft liver is an uncommon condition hitherto recognized only in pediatric patients. We describe two adult cases. Methods. Clinical information was obtained by review ing the medical records. The diagnosis of adenoviral infection was mad e by immunohistochemistry or culture. Results. Both patients had recei ved recent antirejection treatment and presented with fever, hepatic d ysfunction, and progressive leukopenia. One patient had some viral inc lusions resembling those described in herpes simplex infections. Adeno virus was cultured from the liver in both cases and from the lung in o ne case. Both patients were treated by decreasing the immunosuppressio n and intravenous acyclovir, but died. Conclusions. Adenovirus infecti on should be considered when evaluating adult liver transplant patient s with necrotizing lesions or microabscess formation at allograft biop sy. A review of the literature shows that most previously reported inf ections have led to graft loss or death, but occasional remissions of disease are also on record.