{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:28:22Z","timestamp":1786681702121,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Sapovirus is a calicivirus, which commonly causes acute gastroenteritis. However, in immunocompromised patients, chronic infection with diarrhea and failure to thrive has been reported. Due to sapovirus emerging as an infection of concern in our kidney transplant recipients (KTRs), we sought to describe the burden of sapovirus infection in this population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We evaluated adult KTRs with sapovirus diagnosed by stool gastrointestinal polymerase chain reaction (PCR) at our institution. Data were collected retrospectively, and included demographics, symptom burden, treatment course, and patient outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Nine patients met inclusion criteria. The median age was 48 years old. Symptom burden was high, with a median of six patient\u2010reported symptoms per case. Median time from symptom onset to diagnosis was 30 days. All patients reported experiencing diarrhea, and most patients reported dehydration, fatigue, and nausea. Six patients experienced weight loss relative to baseline, and four patients experienced acute kidney injury. Two patients newly required dialysis during the follow\u2010up period, one of these due to an episode of graft rejection with subsequent graft loss. Immunosuppression was reduced in seven cases, and nitazoxanide administered in three patients. Median time from symptom onset to symptom resolution was 45 days, however several patients had very prolonged courses, including symptom duration for over a year.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Sapovirus is an emerging pathogen in KTRs and was associated with significant symptom burden and morbidity, including failure to thrive, acute kidney injury, and need for dialysis. Delays in diagnosis and limited treatment options remain barriers to improving outcomes.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.70302","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:55:26Z","timestamp":1786679726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sapovirus Infection in Kidney Transplant Recipients: A Case Series Demonstrating the Burden of an Enteric Viral Pathogen"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-7860","authenticated-orcid":false,"given":"Alan","family":"Koff","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases University of California Davis Medical Center Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niyati","family":"Narsana","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of California Davis Medical Center Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Len","family":"Sy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1979-4392","authenticated-orcid":false,"given":"Sana","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Division of Transplant Nephrology University of California Davis Medical Center Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"10","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"3674","DOI":"10.1128\/JCM.01087-06","article-title":"Development of an Enzyme Immunoassay for Detection of Sapovirus\u2010Specific Antibodies and Its Application in a Study of Seroprevalence in Children","volume":"44","author":"Farkas T.","year":"2006","journal-title":"Journal of Clinical Microbiology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00011\u201014"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3390\/v13020184","article-title":"Epidemiological and Genetic Characterization of Sapovirus in Patients With Acute Gastroenteritis in Valencia (Spain)","volume":"13","author":"Oliveira\u2010Tozetto S.","year":"2021","journal-title":"Viruses"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiae251"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010019\u20104726\u20104"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.01.023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010024\u201004748\u20104"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03366\u201012"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu880"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31821c9392"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010\u2010024\u201002242\u20109"},{"issue":"2","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.diagmicrobio.2018.05.017","article-title":"Norovirus, Astrovirus, and Sapovirus Among Immunocompromised Patients at a Tertiary Care Research Hospital","volume":"92","author":"Daniel\u2010Wayman S.","year":"2018","journal-title":"Diagnostic Microbiology and Infectious Disease"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"265.e9","article-title":"Chronic Norovirus Infection Among Solid Organ Recipients in a Tertiary Care Hospital","volume":"23","author":"Beek J.","year":"2017","journal-title":"Clinical Microbiology and Infection"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcv.2019.02.001","article-title":"Intrahost Viral Evolution During Chronic Sapovirus Infections","volume":"113","author":"Pietsch C.","year":"2019","journal-title":"Journal of Clinical Virology"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00705\u2010009\u20100358\u20100"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/6846873","article-title":"Successfully Treated Norovirus\u2010 and Sapovirus\u2010Associated Diarrhea in Three Renal Transplant Patients","volume":"2018","author":"Ghusson N.","year":"2018","journal-title":"Case Reports in Infectious Diseases"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010023\u201004695\u20106"},{"issue":"4","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"S514","DOI":"10.1016\/j.healun.2021.01.2072","article-title":"Sapovirus Gastroenteritis in a Lung Transplant Recipient","volume":"40","author":"Richards K.","year":"2021","journal-title":"Journal of Heart and Lung Transplantation"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1394"},{"key":"e_1_2_10_21_1","article-title":"A Phase 2 Multi\u2010Center, Prospective, Randomized, Double\u2010Blind Study to Assess the Clinical and Antiviral Efficacy and Safety of Nitazoxanide for the Treatment of Norovirus in Hematopoietic Stem Cell and Solid Organ Transplant Recipients","author":"Boutin C. A.","year":"2026","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010021\u201006062\u20102"},{"issue":"9","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13550","article-title":"Diagnosis and Management of Diarrhea in Solid\u2010Organ Transplant Recipients: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Angarone M.","year":"2019","journal-title":"Clinical Transplantation and Research"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.70302","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:55:28Z","timestamp":1786679728000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.70302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":22,"alternative-id":["10.1111\/tid.70302"],"URL":"https:\/\/doi.org\/10.1111\/tid.70302","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"assertion":[{"value":"2026-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70302"}}