{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T23:06:10Z","timestamp":1770419170158,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Minimal data exist describing the epidemiology, management, and long\u2010term graft outcomes after West Nile viral disease in kidney transplant recipients (KTRs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center observational cohort study of patients who received a kidney transplant between 1\/1\/1994 and 12\/31\/2018 and developed WNV at any time point after transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 24\u2010year study period, 11 patients had documented WNV infection. Seven patients were recipients of a kidney transplant alone, and four had a simultaneous kidney and pancreas transplant. The mean age at the time of transplant was 44.7\u00a0\u00b1\u00a017.1\u00a0years, and the mean age at the time of WNV infection was 48\u00a0\u00b1\u00a017.2\u00a0years. All patients received lymphocyte depleting induction at transplant (alemtuzumab (n\u00a0=\u00a02), OKT3 (n\u00a0=\u00a01), or anti\u2010thymocyte globulin (n\u00a0=\u00a08)). The mean time from transplant to WNV infection was 3.4\u00a0\u00b1\u00a05.4\u00a0years, and none was suspected of having a donor\u2010derived infection. Three patients were treated for rejection in the 6\u00a0months before infection. The most common presenting symptom was altered mental status (n\u00a0=\u00a07), followed by a combination of fever and headache (n\u00a0=\u00a04). All patients had detectable serum WNV IgM antibodies at the time of diagnosis. All patients had a reduction in their immunosuppression and received supportive care; only two patients were treated with intravenous immunoglobulins. Nine patients recovered with no residual deficit; however, two suffered permanent neurologic damage. The mean estimated glomerular filtration rate drop at 1\u00a0year after the infection was 8.4\u00a0\u00b1\u00a013\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>. Three patients suffered acute rejection within 1\u00a0year after the infection episode, likely attributable to aggressive immunosuppressive reduction. The mean follow\u2010up after the infection was 5.1\u00a0\u00b1\u00a04.3\u00a0years. At last follow\u2010up, two patients lost their kidney allograft, and five patients died. None of the graft losses or deaths occurred within a year of the WNV or were directly attributable to WNV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of patients with WNV infection after KTR recovered fully with supportive care and immunosuppressive adjustment without residual neurologic sequelae. Additionally, WNV infection was associated with relatively small reductions in eGFR at 1\u00a0year.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13317","type":"journal-article","created":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T10:34:31Z","timestamp":1589020471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Epidemiology, management, and graft outcomes after West Nile virus encephalitis in kidney transplant recipients"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8230-3889","authenticated-orcid":false,"given":"Fahad","family":"Aziz","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine University of Wisconsin\u2013Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-981X","authenticated-orcid":false,"given":"Christopher","family":"Saddler","sequence":"additional","affiliation":[{"name":"Division of infectious disease Department of Medicine University of Wisconsin\u2013Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-9727","authenticated-orcid":false,"given":"Margaret","family":"Jorgenson","sequence":"additional","affiliation":[{"name":"Department of Pharmacology University of Wisconsin\u2013Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannina","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of infectious disease Department of Medicine University of Wisconsin\u2013Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine University of Wisconsin\u2013Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"issue":"24","key":"e_1_2_9_2_1","first-page":"521","article-title":"Division of vector\u2010borne diseases NCfE, zoonotic infectious diseases CDC. 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