In infectious mononucleosis anemia and low platelet count (thrombocytopenia) are caused by breakdown of the cells by antibodies and impaired production due to affection of the bone marrow. Though platelet count below 1, 50,000/microL is called thrombocytopenia, normally platelets even lower in number are sufficient to do their work If the neutrophil count is very low, fewer than 500 neutrophils in a microliter of blood, it is called severe neutropenia. When the neutrophil count gets this low, even the bacteria normally living in a person's mouth, skin, and gut can cause serious infections
Low white blood cell count is often a feature of immunodeficiency or a compromised immune system. As you learned in school, white blood cells are the workhorse of the immune system. Low counts of specific white blood cells in the CBC can often reveal the cause of the immunodeficiency If you have HIV, you probably won't get sick with CMV unless your CD4 count, a type of white blood cell, is below 100. Cytomegalovirus Causes and Transmission You probably won't catch CMV from. Neutropenia is a condition in which there are an abnormally low levels of neutrophils (white blood cells) in the blood. Neutropenia can be caused by numerous medical conditions or medications like chemotherapy. Symptoms of neutropenia are skin infections of the skin and other areas of the body, swollen gums, and sore mouth
Some viruses can also cause cancers that affect white blood cell count negatively, Epstein-Barr virus is linked to many cancers, especially nasopharyngeal cancer, but cancer that causes leukopenia, in this case, is Hodgkin's lymphoma. The mechanism by which lymphoma can cause leukopenia will be explained later in the article .CAEBV is a severe illness with unusual EBV activation that may be fatal with multiple organ failure, and it is associated with malignant lymphoma without prior immunosuppression [2, 3].The clinical symptoms of CAEBV and the serologic abnormalities corresponding to. 1. First, take a look at the total white count. In infectious mononucleosis, the white count is usually moderately elevated, usually somewhere in the range of 16-20 (normal for adults is around 5-11). It rarely goes above 35. In AML, however, the WBC is usually markedly elevated (50, or even 100 or more). Granted, if you catch the AML early in.
Glandular fever is a type of viral infection that mostly affects young adults. It is also known as infectious mononucleosis, or mono. Common symptoms include: a high temperature (fever) a severely sore throat. swollen glands in the neck. fatigue (extreme tiredness) While the symptoms of glandular fever can be very unpleasant, most of them. Blood tests revealed a white blood cell (WBC) count of 6,100/Î¼L (with a differential count showing 61% neutrophils, 5% bands, 24% lymphocytes, 7% monocytes, and 1% reactive lymphocytes), hemoglobin of 12.4 g/dL, and platelets of 167,000/Î¼L. Her C-reactive protein was elevated at 113 mg/dL The complete blood count results give information on the immune response that the body is mounting against the EBV virus, as well as whether unusual white blood cells typical of EBV infection are present You may also need certain blood tests, such as: White blood cell count. The presence of certain types of white blood cells (atypical lymphocytes) may support the diagnosis. Antibodies. These may be in the blood in response to certain parts of the EBV or CMV
Impacts of the Epstein Barr Virus (EBV) and my levels were super high plus low white blood cell count, etc Now I'm like what is this. My natural inclination was to do a search if they were related. after reading that it seems its all related. I mean I've had tons of symptoms over the years that people just don't have any answers for RheumaÂtologists could ask lupus patients' family members, especially those who test positive for anti-viral capsid antigen and anti-early antigen, to come back for reevaluations, perhaps annually, while keeping a lookout for the typical signs and symptoms of lupus, such as photosensitivity, low white blood cell counts, oral/nasopharyngeal. Apart from this white blood cell count to check for increased number of white blood cells (lymphocytes) or abnormal - looking lymphocytes may be checked. Lastly platelets count may be checked (that can be decreased) and liver function tests may be done to check any abnormality. Homeopathic Medicines for EBV help treat the condition in a safe. Brief Facts about EBV: --Mono is caused by the Epstein-Barr virus, which is named after the scientists who first identified it in the mid-1960s. The virus enters the lymph nodes and attacks the lymphocytes (the white blood cells manufactured there). As the white blood cells come into contact with the virus, they change shape and multiply Hi XXXXXXX , Epstein-Barr virus causes infectious mononucleosis which is also called glandular fever.During this fever, sore throat, swollen lymph glands like symptoms occur. In infectious mononucleosis anemia and low platelet count (thrombocytopenia) are caused by breakdown of the cells by antibodies and impaired production due to affection of the bone marrow
A normal white blood cell count is generally about 4,500 to 11,000/Î¼L.. White blood cell counts that are too high or too low may be dangerous, depending on the cause. A high white blood cell count is called leukocytosis, which is generally diagnosed when white blood cell levels exceed 11,000/Î¼L Tumors more common in settings of low CD4 counts. Role of EBV PCR (quantitative) of blood uncertain: Ponzoni M, et al. Ganciclovir is associated with low or undetectable Epstein-Barr virus DNA load in cerebrospinal fluid of patients with HIV-related primary central nervous system lymphoma. Clin Infect Dis. 2006;42(4):. It can also cause low counts of certain types of white blood cells even if it doesn't cause low white blood cell count overall. Swelling of the spleen. This can happen in some forms of systemic mastocytosis, and may also happen in some patients with mast cell activation syndrome, although the reason why it happens in MCAS is not as clear They only discover that they have low white blood cells on a routine check-up with their doctor. In most cases the patient lives normally with this problem for their natural life span. It is important to have a 6 monthly blood count if you have low white blood cells to monitor any deterioration
Saved By the D: low white blood cells, vitamin deficiency, and you. So-- remember that whole thing about how I am weird and have an inexplicable lack of white blood cells? If not, let me catch you up. Sometimes my number of white blood cells goes down to an abnormally low level--so low that I get fevers about once a month, and every time a kid. Thrombocytopenia is defined as a platelet count of less than 150 Ã— 103 per ÂµL. It is often discovered incidentally when obtaining a complete blood count during an office visit. The etiology.
Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a mono spot test. EBV-associated diseases. Chronic active EBV infection; Epstein-Barr virus-associated lymphoproliferative diseases; Hodgkin's diseas Approximately 95 percent of us carry a pathogen called the Epstein-Barr virus (EBV). For many, this virus is caught in early childhood and largely goes unnoticed. EBV isn't like most infections that are 'conquered' by our immune system but rather it 'retreats and hides out' in part of our immune system, called our B cells - a type.
. Medical conditions which affect the bone marrow: Aplastic anemia. Vitamin B12 and iron deficiencies. HIV, Epstein-Barr virus, and other viral infections. Cancer treatments. Imbibing in alcohol. Cirrhosis Long-term shedding of EBV in the saliva has been noted after infectious mononucleosis; patients may have low titers of EBV in saliva for up to 18 months after infectious mononucleosis. As many as 20% of healthy carriers intermittently shed virus I lost 10 lb in a week. After a week in the hospital, blood draws twice a day, heavy doses of two major antibiotics, injections to help boost my white count, cultures for CMV , Epstein Barr(?) virus and one other, urinalysis and an ultrasound, the three doctors I saw really didn't know why my white count was so low
A low white blood cell count, called leukopenia, can result from conditions such as: Bone marrow damage (e.g., toxin, chemotherapy, radiation therapy, drugs) Bone marrow disorders â€”the bone marrow does not produce sufficient WBCs (e.g., myelodysplastic syndrome , vitamin B12 or folate deficiency The Epstein-Barr virus (EBV) is a type of herpesvirus that causes infections in those affected. EBV infections can cause a sore throat, headache, and swollen lymph nodes, among other symptoms. Once the person gets infected by Epstein Barr Virus, it may take around 4 to 6 weeks for symptoms to appear. Children do not show any specific symptom of this virus, but the young ones may feel pneumonia, rashes and low white blood count. The young adults and teenagers develop symptoms of mononucleosis Mild thrombocytopenia (low platelet count) and mild neutropenia (low white blood cell count) may accompany mono infection. Enlargement of the spleen and subsequent splenic rupture is a rare, but potentially deadly complication. Due to this potentially deadly complication, patients with infectious mononucleosis should avoid contact sports Epstein Barr Virus Clearing Kit Homeopathy uproots and clears infections so that they are not a problem for you any longer. Symptom Clearing treatment works with the body so that your body itself is doing the killing of the pathogens. It is an immunological treatment. The biggest issue with chronic infections and v
White Blood Cells. White blood cells help fight infections. Signs and symptoms of a low white blood cell count include fevers, frequent infections that can be severe, and flu-like illnesses that linger. Platelets. Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding White blood cells make up our defense against foreign organisms and inner diseases, including autoimmune disease and cancer. They are produced by the bone marrow and have a lifespan of a few weeks. White blood cell count is flexible, and although it has a normal range of 4000-11000 per cubic milliliter, they can change their numbers and increase in response to infections, allergy or cancers A white blood count can show if the number of your white blood cells is too high or too low, but it can't confirm a diagnosis. So it is usually done along with other tests, such as a complete blood count, blood differential, blood smear , and/or bone marrow test . It all sounds like typical mononucleosis, without reason to suspect anything else.But as already advised, you should discuss your WBC, including the differential count (types of cells) with your doctor Infectious mononucleosis is an illness caused by a viral infection. It is commonly called mononucleosis, or mono. Mononucleosis is most often caused by the Epstein-Barr virus. In some cases, it is caused by other viruses. Mononucleosis has been nicknamed the kissing disease. This is because Epstein-Barr virus commonly is transmitted during.
. A complete blood count (CBC) measures the levels of red blood cells, white blood cells, and platelets in your blood. For this test, a small amount of blood is drawn from a blood vessel, usually in your arm. If you have thrombocytopenia, the results of this test will show that your platelet count is low. Blood Smear. A. A full blood count and differential count for lymphocytosis and atypical lymphocytes. Monospot test (heterophile antibodies) in immunocompetent adults. EBV serology test in children younger than 12 years of age and in people who are immunocompromized. The differential diagnosis of glandular fever includes â€¢ Streptococcal pharyngitis: not associated with hepatosplenomegaly. - If failure of streptococcal pharyngitis to improve within 48-72 hr you suspect infectious mononucleosis. â€¢ In patients with extremely high or low white blood cell counts, moderate thrombocytopenia, and even hemolytic anemia Results of the mononucleosis spot test in conjunction with the clinical picture and the lymphocyte-white blood cell count (L/WCC) ratio were analyzed in 120 patients with glandular fever (hereafter, glandular fever group) and 100 patients with bacterial tonsillitis (hereafter, tonsillitis group) attending the ENT Department of St George's. A low white blood count (WBC) count may indicate a(n) _____. viral infection autoimmune deficiency The physician may order a repeat a mono test in a week or so to see if _____ antibodies have developed or may order Epstein-Barr virus (EBV) antibodies to help confirm or rule out the presence of a current EBV infection. White blood cells.
Most of you will never do differential white blood cell counts on the job, but you should know how counts can be used to diagnose infections. You should suspect bacteria if the neutrophils are high, viruses if lymphocytes are high, parasitic worms if eosinophils are high (though allergy is a possibility too), and AIDS if lymphocytes are low Low levels of lgM can be caused by multiple myelomo, some types of leukemia, and some inherited types of immune diseases. Low lgM can also be caused by selective immunoglobulin M (SlgM) deficiency, a rare form of dysgammaglobulinemia. The causes of SlgM deficiency are unknown, and no link to familial inheritance has been established Neutrophils destroy bacteria and fungi with a series of enzymes and turn into pus when they die in battle. In normal settings, they represent 60 to 70% of the total white blood count. The normal white blood cell count is 4,500 to 11,000/Î¼L, but the normal value range may vary from one laboratory to another
The white blood cell differential is often used as part of a complete blood count (CBC) as a general health check. (This testing is sometimes called CBC with differential or CBC with diff for short.) A WBC differential may be used to help diagnose the cause of a high or low white blood cell (WBC) count results seen on a CBC The white blood cell count as the name suggests is a count of the infection-fighting cells in the blood. To a degree, what is considered within the normal range is determined by the laboratory performing the test. Mayo Clinic describes a normal WB.. Blood cancers can produce extremely high white blood cell counts including neutrophil. Other cancers push neutrophils out of the bone marrow as other cell types are abnormally increasing in number. Solid organ cancers, such as liver or pancreas, produce significant inflammation and increase the risk of infection Lymphocytes that become reactive are also abnormal. In this instance, these white blood cells are exposed to foreign antigens. Upon exposure, the lymphocytes become abnormally large. Hepatitis C and the Epstein-Barr virus can lead to this change in size Mononucleosis, hepatitis or a cytomegalovirus infection of the stomach and eyes can also be blamed for an increased amount of these white blood cells. The use of certain medications and blood transfusions might raise the level of lymphocytes in the blood as well
White Cell Count relates to the body's immune system. Recent colds, allergies, infections, or chemical exposures may cause this value to be high or low. Red Cell Count refers to the red blood cells. These cells carry oxygen in the blood. Low values are commonly seen in individuals with certain types of anemia High white blood cell count may be temporary or permanent. Usually, the WBC levels are temporary come back to normal in few hours or days. However, if the count remains higher for longer periods, it denotes alarming health problems in the body Often the basic blood counts are more or less normal, but in other cases there is activation evident by lymphocytosis (i.e. white blood cells are proliferating, usually due to a pathogen or to a malignancy); in many other cases there are low WBC counts of one cell type or another (though most WBC counts don't differentiate between certain white. A complete blood count (CBC) often demonstrates an increased white blood cell count due to absolute lymphocytosis. Atypical lymphocytes and rouleaux may be present. A person can transmit Epstein-Barr virus (EBV) to others as long as the virus is present in his or her throat. This period can last from several months to many years
Chronic Fatigue Syndrome, Environmental Illness, and Low White Blood Cell Count. I feel I must apologise for my recent lack of blogging activity but I'm sure when I explain why you'll understand - plus the reason has given me the inspiration for this post! As regulars will be aware I have suffered from Chronic Fatigue Syndrome (ME/CFS) for a. Epstein-Barr virus infection caused high elevated liver enzymes, enlarged liver, enlarged spleen, and enlarged gallbladder. Neutrophils were very low, white blood counts extremely low, I was dehydrated, had fluctuation of fever up and down, night sweats, was extremely fatigued, had fluid on outside of both lungs (probably from no activity or.
Underlying causes for a low white blood cell count can range from benign disorders, such as vitamin deficiencies, to more serious blood diseases, such as leukemia or lymphoma. A truly low white blood cell count also puts you at higher risk for infections â€” typically bacterial infections. But viral infections also may be a concern EBV-VCA, IgM is an antibody (protein) that is produced by the body in an immune response to an Epstein-Barr virus antigen.. EBV stands for Epstein-Barr virus. Epstein-Barr virus is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection Chronic Epstein Barr virus (EBV) infection in an immunocompetent host has been described however it is not a common entity. It has been linked to many lymphoproliferative disorders and achieves such via many molecular mechanisms, some of which are poorly understood. In addition to infectious mononucleosis, the EBV is linked to various other hematological pathologies and autoimmune disorders
7 Natural Remedies For Epstein Barr Virus. Epstein Barr Virus (EBV), also known as mononucleosis or mono, is a virus that is transmitted from human to human through body fluids. EBV is commonly referred to as the kissing disease but can be spread through many different types of contact including through the blood and seminal fluid. Although. Infectious diseases are common causes of monocytosis, especially chronic infections such as TB, typhoid and brucellosis. However, during acute bacterial infections, blood monocyte count may also be increased as part of leucocytosis, and therefore monocytosis is more significant when the total white cell count is not increased In the event of vitamin D deficiency, the antimicrobial peptide cathelicidin is low. A 2008 study in the Journal of Allergy and Clinical Immunology supplemented 14 subjects with 4,000 international units of vitamin D daily over three weeks and found that the white blood cells produced more cathelicidin
The only thing that came back wrong was a low white blood cell count. So for the next month, my family care doctor ordered three more CBC tests, along with a SED Rate test, Peripheral Smear (immaturity not observed), CRP C-REACTIVE PROTEIN, Parvovirus, IRON AND TBC, HIV, HEPATITIS PANEL ACUTE, EPSTEIN-BARR VIRUS, and COMP METABOLIC PANEL blood. Because leukocytosis is the rule in infectious mononucleosis, the presence of a normal or decreased WBC count should suggest an alternative diagnosis Vitamin B12 And Folate - Any deficiencies in these vitamins cause a low platelet count, anemia, and a low white blood cell count (known as leukopenia). Hepatitis B, C, and HIV - These are viral infections often associated with low platelets. If you have a low platelet count and test positive for these infections, they are the cause of the. Thikra Abdullah Mahmood, Heider Hemeed Abbas, Saif Jabbar Yasir, Epstein-Barr Virus Infection Related to Low White Blood Cell Count in Cancer Patients Receiving Chemotherapy in Al-Najaf Governorate/Iraq, Journal of Pure and Applied Microbiology, 10.22207/JPAM.14.2.59, 14, 2, (1609-1617), (2020) The peripheral white blood count (WBC) will usually show a low WBC of 4000-6000; lymphocyte predominance of greater than 50% will be present on the differential. Atypical lymphocytes of 10% may be present in CMV mononucleosis. CMV-induced hepatitis produces an increase in: Serum transaminases to 4-10 fold above norma
. Usually, red blood indices are normal; Low platelet count; White blood cell and red blood cell counts are low Unusual looking white blood cells. In mononucleosis, lymphocyte counts may not only be elevated, but the cells are also atypical in appearance. It's often the earliest sign of EBV infection. ï»¿ ï»¿ Under the microscope, a percentage of white blood cells (WBC) will have more cytoplasm, making them larger The Epstein-Barr virus blood test is not a diagnostic test. It only tells if you are infected with the Epstein-Barr virus; it cannot tell how severe the infection is. Mononucleosis is a viral infection that causes the body to produce an abnormally high number of white blood cells, or lymphocytes Total white blood cell count was significantly increased in the tonsillitis group compared with the mononucleosis group (16,560 cells per microliter vs. 11,400 cells per microliter), but the.
Similar to Rickettsia, Ehrlichia can cause flu-like symptoms as well as low white blood cell count, says Dr. Reihman, since it infects white blood cells called monocytes in humans. It's also. The Epstein-Barr virus (EBV) is a common virus that's part of the herpes virus family. It causes infectious mononucleosis, or mono. Mono is passed from person to person through saliva. Symptoms usually appear within 4 to 6 weeks after exposure and ease in 1 to 2 months. If you have mono, you may have a high level of a type of white blood cell.
A low level of the type of white blood cells known as neutrophils during chemotherapy is referred to as chemotherapy-induced neutropenia. All of the different types of white blood cells may be affected with bone marrow suppression, but suppression of the number of neutrophils is most important in raising the risk of infection Dr. Margot Watson answered. 54 years experience Gynecology. No: A complete blood count only measures the number and type of white blood cells and red blood cells. There are very specific blood tests for mononucleos Read More. 1 doctor agrees. 0. 0 comment. 2 The white blood cell (WBC) count indicates the number of white blood cells in a sample of blood. This count provides a clue to the presence of illness. White blood cells are made in the bone marrow and protect the body against infection and aid in the immune response. If an infection develops, white blood cells attack and destroy the bacteria.
Q: my dr's office called and told me my white blood cell count was low and they wanted to do more blood work, but not until the end of April. I asked them what it meant if it was low and all they told me was it was only down by a tenth and it was no big deal they just wanted to test me again in 6 months ABSTRACT: A scheme-based approach, supported by a simple mnemonic, can narrow the broad differential diagnosis of thrombocytopenia. This approach uses findings from the complete blood cell count and the peripheral smear to organize the possible causes of thrombocytopenia into those that affect only platelet count, those that produce both a low platelet count and hemolytic anemia, and those. Epstein-Barr virus (EBV) antibodies are a group of tests that are requested to help diagnose a current, recent, or past EBV infection. EBV is a member of the herpes virus family. Passed through the saliva, the virus causes an infection that is very common. As many as 95% of people in the United Kingdom will have been infected by EBV by the time they are 40 years old Symptomatic primary Epstein-Barr virus infection is a usually self-limiting illness in adolescents. We present a case of an adolescent who had been receiving azathioprine for inflammatory bowel disease for four years and developed a life-threatening primary Epstein-Barr virus infection successfully treated with rituximab. An 11-year-old girl presented with chronic, bloody diarrhea
Her Lymphocyte count was normal. She was tested for mono and it was negative, she does not have any herpes etc virus these test were also done as well. Yes I to agree the white blood count would be up not down, the red counts are all normal. Low absolute netrophils 1473 range should be 1800 - 8000. Absolute lymphocytes are. 1194 range 1200- 5200 The absolute lymphocytes count can be calculated by multiplying the total number of white blood cells against the percentage of white blood cells which are lymphocytes. If the white blood cell count is 8000, and 20% of those white blood cells are lymphocytes, that means the absolute lymphocytes count would be 1600 (8000 x 0.2) Plasmapheresis reduces IgM to safe levels and makes the blood less viscous. But it does not affect the lymphoma cells that produce the IgM antibody. Other treatments Patients with low levels of red blood cells, white blood cells, or platelets may be given transfusions, antibiotics, or medicines. WM can develop into an aggressive form of lymphoma The condition lymphocytopenia, or lymphopenia, is characterized by abnormally low lymphocyte levels. Lymphocytes are a kind of white blood cell that is part of your immune system. Low lymphocyte count is a cause for concern because when lymphocytes (a type of white blood cell) are low, the body's ability to repel infections is weakened Blood Urea Nitrogen (BUN) BUN is a waste product derived from protein breakdown in the liver and excreted by the kidneys. When your kidneys are not working well, the level of BUN in the blood will rise. Dehydration and blood loss can also cause a high BUN level. Liver disease, a low protein diet, or too much water intake may cause a low BUN level
Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cells called lymphocytes, where multinucleated Reed-Sternberg cells (RS cells) are present in the patient's lymph nodes. Symptoms may include fever, night sweats, and weight loss. Often there will be non-painful enlarged lymph nodes in the neck, under the arm, or in the groin low white blood cells, low segmented neutrophils, viral infections including CMV,EBV,HIV and other blood related cancers like leukemias. DOC EK : yes it can present with a low white blood count as well. DR.EHTISHAM, Doctor. Category: Medical. Satisfied Customers: 9,142 The lymphs blood test is not specific, so a diagnosis cannot be determine by a simple count. Follow-up tests are typically ordered if there is a low or high lymphs count. Most people who have this blood test will have a count that falls within the normal range. For those who do not, here are what the results of the test may mean To the article published 08/05 regarding Rythmol and low white blood count, the answer is yes I have a low WBC of 3.8 and a low neutrophil abs of 1.94 my doc is repeating this in 2 weeks. I have a-fib/SVT a rhythm problem and also take Rythmol 150mg 3x a day, let me know if you found out anything
Effects of Too Many White Blood Cells. At the time of diagnosis, patients can have very, very high white blood cell counts. Typically a healthy person has a white blood cell count of about 4,000-11,000. Patients with acute or even chronic leukemia may come in with a white blood cell count up into the 100,000-400,000 range low platelet count elevated white blood count Low Blood Platelets 70,000 side effects of sotalol WHAT CAUSES A LOW ABSOLUTE MONOCYTE COUNT? Low Platelelet count / Hep-C / Fatty Liver Can someone be fully cured from leukemia? 5 Yr Old with High WBC, High Sed Rate and High Platelet Count - Need for Concern? Low TLC (WBC Total) and low platelet count
Peripheral blood film. A peripheral blood film will provide information on the following: The erythrocytes (RBCs): a note will be made of their size, shape, any membrane changes, colour and stippling. Any inclusion bodies (eg, Howell-Jolly bodies or malarial parasites) will also be noted Low B12, High RBC, High Hematocrit, Low MCH and MCHC. Acute chest syndrome. Low Platelets. Microcytic anemia, normal iron, adult. Low platelets and low neutrophils in 15 mos old. questioning paternaty due to blood types i am 19/m. Hemoglobin Koln. Blood results low hgb mcv. Low WBC Causes of low blood cell counts in children include leukemia, chemotherapy or radiation treatment, and lack of sufficient vitamin B-12 in the diet, states Children's Health Network. An infection such as tuberculosis and mononucleosis or an autoimmune disease, including lupus, may be responsible for low blood cell count NULOJIX Â® (belatacept) is a prescription medicine used to prevent transplant rejection in adults who have received a kidney transplant. NULOJIX, an intravenous infusion, is used with corticosteroids and certain other medicines. It is not known if NULOJIX is safe and effective in children under 18 years old or in people who receive any other organ transplant