COLD virus endangers heart transplants in children, study says

Wednesday, May 16th 2001, 12:00 am
By: News On 6

BOSTON (AP) _ Many heart-transplant failures in children appear to be caused by a common cold virus that infects the organ, scientists say.

Cardiologist Dr. Girish Shirali, who did some of the research at the Medical University of South Carolina, said the same type of virus could be spoiling transplants of lungs, kidneys and other organs and may even be contributing to ordinary heart disease.

``The big, huge question is: Could this have implications for healthy people as well?'' he said.

The researchers, led by scientists at the Baylor College of Medicine and Texas Children's Hospital in Houston, published their findings in Thursday's New England Journal of Medicine.

The germ, known as the adenovirus, can cause colds and the common childhood ailment pinkeye.

More rarely, the virus has been implicated in a heart inflammation known as myocarditis. The adenovirus appears to attack the lining of heart arteries, leading to blockages.

Transplant patients can die or need a new transplant when their bodies reject the new organ.

Researchers have long suspected that some heart-transplant failures are caused by viruses. Transplant patients must take drugs to suppress their immune systems and prevent organ rejection, and that makes them vulnerable to viruses.

But the latest findings could come as a surprise to many cardiologists, because many researchers have suspected that other viruses _ and not the adenovirus _ were to blame when heart transplants go bad.

``The adenovirus seems to be a much bigger player than we previously thought,'' said Dr. Kenneth Schowengerdt, a University of Florida cardiologist who reviewed the findings.

Though soldiers were once given a vaccine against the adenovirus, there is no proven treatment now in use.

The researchers studied heart tissue samples from 149 transplant patients _ newborns to 18-year-olds _ at Loma Linda University Children's Hospital in California. They did DNA tests and found viral infections in 34 patients, or 23 percent. Among them, 24 patients had the adenovirus.

Following the patients for six years, the scientists found the risk of complications was 11 times higher for children with viral infections.

For children with the adenovirus, the survival rate of the transplant after five years was 62 percent, versus 96 percent for youngsters with no detected viral infection.

About 75 percent of the roughly 270 children who undergo heart transplants each year in the United States survive for at least five years.

Dr. Robin Avery, an infectious-disease expert at Cleveland Clinic Foundation, said the role of the adenovirus is intriguing, but it is possible that the virus accompanies heart transplant complications without causing them.

One of the Baylor researchers, pediatric cardiologist Dr. Jeffrey Towbin, said heart transplant candidates should be screened for such viruses. He said the vaccine should be produced again, and an antibody drug could probably be developed, too.