Health Considerations

Viral Infections

Viral Infections

As a transplant recipient your immune system will be suppressed by anti-rejection drugs (also known as immunosuppressants) to stop your body from attacking your transplanted organ. This means your body is less able to fight genuine external invaders like the viruses listed below, which are all common amongst the general population. Certain viruses may be present in the body without causing any symptoms or long-term harm; people who have a virus without any symptoms are ‘asymptomatic’ but the virus might sometimes be passed on to others. If you are immunosuppressed, you are more likely to experience symptoms as your immune system is less able to fight the virus. You should be aware of the signs of infection because you might need treatment, such as anti-viral medication, to help your body fight these viruses.

  • Cytomegalovirus (CMV)

    What is CMV?

    CMV is spread through bodily fluids and can cause a flu-like illness. You can become infected at any age, usually without knowing about it, and the virus will stay in your body your whole life without causing any harm. 60-100% of people are infected with CMV.

    Why am I at risk?

    You, your transplanted organ or both, may have already been infected with CMV before your transplant. However, after having a transplant your anti-rejection drugs suppress your immune system, meaning it is less able to fight the infection, and you can be at risk of developing symptoms.

    What are the symptoms?

    The symptoms of CMV infection include a high temperature (fever), a sore throat, swollen glands and flu-like symptoms. If you have any of these symptoms contact your transplant team who will be able to advise on treatment.

    How is CMV detected?

    If your immune system can no longer stop CMV from multiplying, the levels of virus in your blood will increase. This can be measured by a blood test and is known as ‘CMV viral load’.

    How is it treated?

    If you or your transplanted organ are known to have CMV, you will usually be given anti-viral medication after your transplant to help keep the levels of virus in your body low and prevent the development of symptoms. If you later develop symptoms you may need further treatment with anti-viral medication.

  • BK polyoma virus

    What is BK polyoma virus?

    BK polyoma virus is a type of virus that can affect the kidneys. Up to 100% of the population may have the virus but it usually does not cause any symptoms.

    What are the symptoms?

    In kidney transplant recipients, BK polyoma virus can cause damage to the kidneys (known as BK nephropathy). There are often no symptoms except that kidney function may be reduced.

    How is it detected?

    BK polyoma virus can be detected by a kidney biopsy, a blood test or a urine test. Your transplant team will decide what is appropriate for you.

    How is it treated?

    The usual treatment for BK polyoma virus infection is to temporarily reduce your anti-rejection drugs to allow your own immune system to fight the virus.

  • Epstein-Barr virus (EBV)

    What is EBV?

    EBV is spread by saliva and can cause glandular fever. In transplant recipients it can also cause a type of cancer known as post-transplant lymphoproliferative disorder (PTLD). This occurs when your body makes too many of one type of blood cell (lymphocytes), and lymph nodes (small glands) around the body appear swollen.

    What are the symptoms?

    EBV infection can cause general symptoms that are seen with other viral infections such as a fever. Symptoms of glandular fever include a high temperature, a very sore throat, swollen glands in your neck and tiredness lasting sometimes several weeks after the illness. Symptoms of PTLD include swollen lymph nodes, tiredness and a high temperature, but there sometimes can be no symptoms, speak to your transplant team if you have concerns.

    How is EBV detected?

    Levels of EBV can be detected by a blood test but routine testing is usually only carried out in the first year after your transplant operation when you are considered high risk.

    How is it treated?

    The symptoms of glandular fever usually resolve without treatment within two or three weeks. If you have PTLD you may be treated in several ways; your anti-rejection drugs may be temporarily reduced to allow your own immune system to fight the virus, you may receive a drug which contains antibodies against the infected blood cells and in some cases chemotherapy might be necessary.

  • Chickenpox and shingles (varicella zoster virus)

    What is varicella zoster?

    Varicella zoster is the virus that causes chickenpox. If you have had chickenpox, the virus stays in your body and can reactivate to cause shingles. A blood test can check if you are immune to chickenpox.

    What are the symptoms?

    Chickenpox can be recognised by the characteristic spots that appear all over the body. Shingles occurs when the virus travels down a nerve and results in a painful rash on the skin around that nerve.

    When am I at risk?

    If you have never had chickenpox, or you are not sure, you should avoid direct contact (being in the same room) with someone who has chickenpox as the virus can spread through the air. If this does happen, contact your transplant team immediately.

    What is the treatment?

    If you have never had chickenpox and think you have been exposed to it, you might need anti-viral treatment. In some cases, hospital treatment is needed, which involves administration of the proteins (antibodies) from the blood of somebody who is already immune to chickenpox. If you develop symptoms of shingles, you should tell your transplant team immediately as antiviral treatment can help alleviate the symptoms.

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