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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Norovirus infection causes significant morbidity in solid organ transplant (SOT) recipients, yet few treatments are available and evidence for efficacy is sparse. In this scoping review, we identify and evaluate potential interventions for managing norovirus infections in SOT recipients.
We searched electronic databases from inception to 6th July 2025. Eligible studies were analyzed for participants’ characteristics, intervention types and reported outcomes.
After screening 245 abstracts, 57 studies were included (one randomized controlled trial (RCT), 27 cohort studies, 5 case series and 24 case reports), mainly from the United States (US). Transplant types included kidney (n=36), liver (n=12), cardiac (n=12), pulmonary (n=7), pancreas (n=6), small bowel (n=7), and multiorgan (n=13) transplants. The most frequently reported primary outcome was resolution of gastrointestinal (GI) symptoms. Interventions were diverse: immunosuppression modification (n=14), nitazoxanide (n=6), intravenous immunoglobulin (IVIG) (n=3), oral immunoglobulin (n=9), combination of these (n=19), faecal transplant (n=2), supportive management (n=4), and others not classified (n=5). Limited quality evidence for positive clinical outcomes was reported for immunosuppression modification (n=6/13), nitazoxanide (n=4/6), IVIG (n=2/3), oral immunoglobulin alone (n=9/9), faecal transplant (n=2/2), supportive treatment (n=4/4), and a combination of treatments (n=11/19). A lack of clinical improvement was described in 13 of 57 studies.
Table 1. Study characteristics (n=57)
Study characteristics
Value
Publication year, n (%)
Before 2000
0
2000-2009
3 (5)
2010-2019
29 (51)
2020 onwards
25 (44)
Study type, n (%)
RCT
1 (2)
Cohort
Prospective
6 (11)
Retrospective
21(37)
Case series
5 (9)
Case reports
24 (42)
Sample size, n (%)
0-9
32 (56)
10-49
10 (18)
50-99
7 (12)
100-199
>200
Population subgroups, n (%)
Adults
44 (77)
Children
13 (13)
Type of transplant, n (%)
Kidney transplant alone
28 (49)
Solid organ transplants including kidney, heart, lung, liver intestine and combined multiple transplants
36 (63)
Solid organ transplants and others (haemopoietic stem cell transplants, immunosuppressed patients including haematological malignancies and solid tumours)
Interventions*, n (%)
Immunosuppressive therapy modification alone
14 (25)
Nitazoxanide alone
Intravenous immunoglobulin therapy alone
Oral immunoglobulin therapy alone n
9 (16)
Combination of treatments
17 (30)
Faecal microbiota transplant
2 (4)
Supportive management
4 (7)
Others
Reported outcomes, n (%)
Improvement in GI symptoms
38 (67)
Improvement of extra-GI symptoms
Reporting of graft-related outcomes (stable function/rejection)
8 (14)
Evidence of eradication of norovirus in stool
No/minimal improvement in symptoms
13 (23)
Reporting of adverse drug reactions
* One study was conducted with multiple treatment arms.
Figure 1 and 2 included as follows.
A wide range of interventions has been used to manage norovirus infections in SOT recipients; however, the evidence is limited to observational studies, and the findings are uncertain. High-quality RCTs are needed to establish treatment efficacy and safety.
