Background. The contribution of respiratory viruses to respiratory disease
in adult liver transplant (LT) recipients has not been studied, We performe
d a prospective audit to document the incidence of respiratory syncytial vi
ruses ([RSVs], parainfluenza virus, influenza virus, and adenovirus) after
LT, and to determine their contribution to respiratory disease in this sett
ing.
Methods. Consecutive adult recipients were followed for 8 months after LT.
Throat swabs were collected weekly for up to 12 weeks after LT, and virolog
ical surveillance was performed using conventional techniques (direct immun
ofluorescence and cell culture). A polymerase chain reaction assay for RSV
was subsequently performed on selected specimens. Clinical data, including
episodes of respiratory disease, were also recorded.
Results. During the study period, 51 patients received 53 LT, Five patients
died, but no viruses were isolated from these patients at any stage. A tot
al of 323 swabs were examined by conventional techniques and yielded 35 vir
al isolates (10.8%). Herpes simplex virus (type 1) accounted for 33 isolate
s, none of which were associated with respiratory disease. Two of 323 swabs
(0.62%), in 2 patients, yielded respiratory viruses (both RSV); both patie
nts had self-limiting, mild, upper respiratory tract symptoms. In these 2 p
atients, the polymerase chain reaction assay was more sensitive than conven
tional techniques and was able to detect extended RSV excretion. Of 51 reci
pients, 31 (61%) were always negative for viruses. Of 51 recipients, 10 dev
eloped respiratory failure, but no respiratory viruses were isolated from a
ny of these patients.
Conclusions. Respiratory viruses are rarely isolated from adult recipients
after LT and are not associated with serious morbidity or with mortality. R
outine surveillance for respiratory viruses in this patient population is n
ot justified on the basis of this study.