Sapovirus – An emerging pathogen in renal transplant recipients?

Purpose After including sapovirus to the viral GI-screening routine of our institution's laboratory, we noticed an increasing number of sapovirus diagnosis among kidney transplant recipients. Therefore, we assumed former GI-tract infections with unidentified pathogens could have been caused by sapovirus as well. In order to better understand the characteristics of a sapovirus infection in a high-risk group we initiated this study. Methods 13 renal transplant recipients with GI-tract symptoms and later identified viral/unknown pathogens were included. Four patients suffered from a sapovirus infection. Kidney function, levels of immunosuppressants, CRP-levels and acid-base balance at admission and dismission, as well as onset of symptoms and time of hospitalization were analyzed. Results Even though statistically not significant, creatinine levels at admission tended to be higher in sapovirus patients (p = 0,710, sapovirus: 3,3 mg/dl (1,3; 5,0), non-sapovirus: 2,5 mg/dl (1,1; 4,9)). Also, Tacrolimus levels at admission showed the same trend (sapovirus: 13,6 ng/ml (12,9; 13,6), non-sapovirus: 7 ng/ml (2,6; 22,6), p = 0,279). At dismission creatinine levels improved equally in both groups (sapovirus: 1,7 mg/dl (1,4; 3,2), non-sapovirus: 2 mg/dl (1,0; 3,6), p = 0,825). Conclusion Especially in high-risk patients early symptomatic treatment remains crucial to protect the transplant's function. In our cohort all patients recovered equally well from the sapovirus infection as well as from other viral GI-tract pathogens. Larger cohorts and long-time follow-ups are needed in order to detect the long-term consequences and a potential need for further research regarding specific treatment. Trial registration number: DRKS00033311 date : December 28th 2023