Single-Center Survey of Prevalence of Viruses in Pediatric Liver Explants.
Academic Article
Overview
abstract
BACKGROUND: Adenovirus has been implicated as a cause of acute liver failure (ALF) following a global outbreak of adenovirus-associated ALF in 2021. To understand any association between viral infection and ALF, it is important to know the baseline prevalence of that virus in children undergoing liver transplant for acute and chronic liver disease (CLD). Our objective was to perform retrospective evaluation of prevalence of common hepatotropic viruses among children who underwent liver transplant at our center. METHODS: We studied 33 stored frozen hepatic explant samples (originally collected between 2004 and 2021 as part of a liver repository) which fell into three categories: ALF (n = 18), acute on chronic liver failure (ACLF, n = 7), and CLD (n = 8). DNA was extracted from the samples, and viral PCR testing was performed for adenovirus, EBV, CMV, and HHV-6. RESULTS: Adenovirus was detected in a single case of indeterminate ALF transplanted in 2019. CMV was detected in two cases, and there were no EBV positive specimens in any group. HHV-6 was more prevalent with 21 of 33 specimens testing positive including ALF, ACLF, and CLD cases. CONCLUSION: This retrospective study of common childhood virus prevalence in liver explants provides important baseline information for studying potential viral etiologies of ALF. We did not identify any clusters of infections. The most frequently occurring virus and only virus found in all categories was HHV-6, underscoring the high prevalence in this heterogenous group. Adenovirus was identified in 1 out of 18 of ALF samples, but likely was not a hepatic pathogen.
