{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:52:51Z","timestamp":1787500371834,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Norovirus is the most common cause of viral gastroenteritis. Studies in adult kidney recipients have documented significant morbidity associated with norovirus infection, but there are few studies in pediatric recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicenter retrospective cohort study of pediatric kidney transplant recipients with norovirus, confirmed by stool PCR, between January 1, 2008, and December 31, 2018. Outcomes of interest included duration of diarrhea, incidence of chronic diarrhea, management strategies, and graft function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty pediatric kidney transplant recipients from four centers were identified for inclusion. Median age at transplant was 5.4\u2009years (IQR 2.2\u201311.2\u2009years), and median time post\u2010transplant was 1.9\u2009years (IQR 0.8\u20133.8\u2009years). Median diarrheal duration was 16\u2009days (IQR 6.0\u201341.5\u2009days); 15 patients (43%) had acute diarrhea, 8 (23%) had persistent, and 12 (30%) had chronic diarrhea. Twenty\u2010one (53%) patients developed acute kidney injury. Thirty\u2010five (88%) patients required supplemental fluids, 8 (20%) patients underwent immunosuppression reduction for a median of 22\u2009days, 5 (13%) were treated with nitazoxanide, and 5 (13%) received oral immunoglobulin. Acute rejection was diagnosed in 3 (8%) patients within 6\u2009months of norovirus diagnosis. We observed no sustained decline in eGFR at 12\u2009months after diarrhea resolution (median eGFR difference: 2.8\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      [IQR: \u221217.1, 7.4]). Of the patients in the cohort, two lost their graft at 6.8 and 30.0\u2009months after the onset of diarrhea.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Norovirus is associated with significant morbidity in pediatric kidney transplant recipients. Various treatment interventions are being employed for norovirus infection. Larger studies, both observational and interventional, are needed to determine the optimal treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.14821","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T23:44:25Z","timestamp":1720741465000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Norovirus Management and Outcomes in a Multicenter Pediatric Kidney Transplant Population"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-7951","authenticated-orcid":false,"given":"Rachel\u00a0M.","family":"Engen","sequence":"first","affiliation":[{"name":"University of Wisconsin Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-717X","authenticated-orcid":false,"given":"Michelle","family":"Keyser","sequence":"additional","affiliation":[{"name":"University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4063-5671","authenticated-orcid":false,"given":"Ziou","family":"Jiang","sequence":"additional","affiliation":[{"name":"University of Minnesota Clinical and Translational Science Institute  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5824-7856","authenticated-orcid":false,"given":"Sarah","family":"Kizilbash","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908\u2010016\u20100524\u2010y"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1301022"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/AJT.13227"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12820"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31821c9392"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/7942515"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2006.03128.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13186"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/PETR.13582"},{"key":"e_1_2_8_11_1","unstructured":"A. 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