HERPES-SIMPLEX ESOPHAGITIS AFTER RENAL-TRANSPLANTATION

This paper describes five renal transplant recipients, out of a series of 221 consecutive patients, who developed herpes simplex esophagitis . This opportunistic infection presented as odyno- and/or dysphagia. I t occurred during or shortly after treatment of acute cellular rejecti on episodes with high doses of steroids and, in four cases, of anti-ly mphocyte globulins. The infection responded to acyclovir in all patien ts. We conclude from these observations that herpes esophagitis occurs during periods of intensive immunosuppression. Because its endoscopic manifestations are variable, biopsies and cultures are essential to r each the diagnosis. Prevention may be possible by avoiding transplanta tion from a seropositive donor to a negative recipient and by prophyla ctic oral acyclovir.