Sapovirus – An emerging pathogen in kidney transplant recipients? - SAPONEPH

Purpose Diarrhea is a common disease but especially in immunocompromised patients it can lead to tremendous outcomes. After including sapovirus to the viral gastroenteritis screening routine of our institutions laboratory, we noticed an increasing number of sapovirus diagnosis among kidney transplant recipients. Therefore, we assumed former GI-tract infections with unidentified pathogens could have been caused by sapovirus as well. In order to better understand the characteristics of a sapovirus infection in a high-risk group we initiated this study. Methods 13 kidney transplant recipients with gastrointestinal tract symptoms and later identified viral/unknown pathogens were included.. Kidney function, levels of immunosuppressants, CRP-levels and acid-base balance at admission and discharge, as well as onset of symptoms and time of hospitalization were analyzed. Results Sapovirus was detected in four patients as cause of diarrhea (Norovirus: 3, CMV: 1, IBD: 1, unknown: 4). Even though statistically not significant, creatinine levels at admission tended to be higher in sapovirus patients (p = 0,710, sapovirus: 3,3 mg/dl (1,3; 5,0), non-sapovirus: 2,5 mg/dl (1,1; 4,9)). Also, Tacrolimus levels at admission showed the same trend (sapovirus: 13,6 ng/ml (12,9; 13,6), non-sapovirus: 7,1 ng/ml (2,6; 22,6), p = 0,279). At dismission creatinine levels improved equally in both groups (sapovirus: 1,7 mg/dl (1,4; 3,2), non-sapovirus: 2 mg/dl (1,0; 3,6), p = 0,825). Conclusion Especially in high-risk patients early symptomatic treatment remains crucial to protect the transplants function. In our cohort all patients recovered equally well from the sapovirus infection as well as from other viral GI-tract pathogens. Larger cohorts and long-time follow-ups are needed in order to detect the long-term consequences and a potential need for further research regarding specific treatment.