Evaluation of Varicella Zoster Virus Infection Morbidity and Mortality in Pancreas and Kidney-Pancreas Transplant Recipients

BackgroundSolid organ transplant recipients are at increased risk of infection due to chronic immunosuppression. The incidence of varicella zoster virus (VZV) infection is known to be increased in these patients compared with the immunocompetent population. Previous reports suggested that these patients are likely to experience a morbid disease course. Few data currently exist on the course of VZV infections in pancreas or pancreas plus kidney (PK) transplant recipients.ObjectiveThe goal of this study was to evaluate the incidence and severity of VZV infections in pancreas or PK recipients.Study DesignWe analyzed the transplantation patient database of the Royal Victoria Hospital, identifying 137 pancreas or PK transplantation procedures performed between January 1999 and October 2010, among which we included 98 patients in the study. We subsequently performed a retrospective chart review to evaluate the incidence and severity of VZV infections posttransplantation.ResultsOur analysis revealed that 11/98 patients developed VZV infections. The majority of infections (∼90.9%) occurred within the first 5 years. Most patients (63.6%) were treated on an outpatient basis, whereas only 4 (36.4%) were hospitalized with a mean hospital stay of 9.5 ± 8.42 days. The initial immunosuppressive regimen remained unchanged for the majority of patients. All patients experienced a mild disease course without intensive care unit admission or death. Only 3 patients (27.3%) developed postherpetic neuralgia.ConclusionThese findings suggest that with timely diagnosis and proper treatment, most patients recover well from a VZV infection.