{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T10:00:44Z","timestamp":1778925644194,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T00:00:00Z","timestamp":1479859200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>Norovirus is a common self-limiting gastrointestinal infection, but in transplant recipients, symptoms can last for months and result in serious health complications. As there is currently no established treatment for chronic norovirus infection in transplant patients, management has been directed at symptom control, trial of various antivirals, and ultimately reductions in immunosuppression. We present 3 cases of chronic norovirus infection in cardiac transplant patients to illustrate various approaches to diagnosis, the prolonged nature of disease symptoms, and treatment options. When managing a transplant recipient with chronic diarrhea, considering a broad differential as well as maintaining a high suspicion for infectious etiologies is key. A stepwise approach to management includes termination of diarrhea-causing medications, trials of nitazoxanide and immunoglobulin, and reductions in immunosuppressive therapies. Although brief discontinuation of immunosuppression is often required to achieve symptom, graft rejection is often a complication.<\/jats:p>","DOI":"10.1177\/1526924816679843","type":"journal-article","created":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T21:20:30Z","timestamp":1479936030000},"page":"69-72","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Chronic Norovirus Infections in Cardiac Transplant Patients"],"prefix":"10.1177","volume":"27","author":[{"given":"Paul T.","family":"Jurgens","sequence":"first","affiliation":[{"name":"School of Medicine, University of Colorado, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Advanced Heart Failure and Transplantation, University of Colorado School of Medicine, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrut V.","family":"Ambardekar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Advanced Heart Failure and Transplantation, University of Colorado School of Medicine, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen K.","family":"McIlvennan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Advanced Heart Failure and Transplantation, University of Colorado School of Medicine, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,11,23]]},"reference":[{"key":"bibr1-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu880"},{"key":"bibr2-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-12-325886"},{"key":"bibr3-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12472"},{"key":"bibr4-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2011.01330.x"},{"key":"bibr5-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01320.x"},{"key":"bibr6-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12212"},{"key":"bibr7-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2013.09.026"},{"key":"bibr8-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1207742"},{"key":"bibr9-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2014.07.014"},{"key":"bibr10-1526924816679843","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1000236"}],"container-title":["Progress in Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526924816679843","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1526924816679843","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526924816679843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:39:08Z","timestamp":1777700348000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1526924816679843"}},"subtitle":["Considerations for Evaluation and Management"],"short-title":[],"issued":{"date-parts":[[2016,11,23]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1177\/1526924816679843"],"URL":"https:\/\/doi.org\/10.1177\/1526924816679843","relation":{},"ISSN":["1526-9248","2164-6708"],"issn-type":[{"value":"1526-9248","type":"print"},{"value":"2164-6708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,23]]}}}