Dohna‐Schwake C, Fiedler M, Gierenz N, Gerner P, Ballauf A, Breddemann A, Läer S, Baba H. A, Hoyer P. F. Primary HHV 6 infection after liver transplantation with acute graft rejection and multi‐organ failure: Successful treatment with a 2.5‐fold dose of cidofovir and reduction of immunosuppression.
Pediatr Transplantation 2011: 15: E126–E129. © 2010 John Wiley & Sons A/S.
Abstract: HHV type 6 has been reported with enhanced pathogenicity in immunocompromised patients. Herein, we report about a two‐yr‐old girl who experienced primary HHV 6 infection after liver transplantation. She clinically presented with graft rejection and necrotic hepatitis as well as high fever, pneumonitis with respiratory failure and a rash. Therapy with cidofovir of 5 mg/kg per wk did not show improvement, so that a full pharmacokinetic profile of cidofovir was performed. It demonstrated enhanced body weight normalized clearance of cidofovir and cidofovir dosage was augmented to 12 mg/kg per wk to reach adequate drug exposure. With additional reduction of immunosuppression, the patient dramatically improved and liver function stabilized.