Association of cytomegalovirus genotype with graft rejection after liver transplantation.
Association of cytomegalovirus genotype with graft rejection after liver transplantation.
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巨细胞病毒基因型与肝移植后移植物排斥反应的关联。
DOI：
10.1097/00007890-199812270-00010
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发表时间：
1998
期刊：
影响因子：
6.2
通讯作者：
Chou,S
中科院分区：
文献类型：
--
作者：
Rosen,HR;Corless,CL;Rabkin,J;Chou,S
背景：人巨细胞病毒（CMV）包膜糖蛋白gB是四种主要基因型之一.一些先前的研究提出了CMV gB基因型与移植和人类免疫缺陷病毒感染人群中有症状感染的频率和临床结局的关系。我们的目的是确定CMV gB基因型的分布和对急性细胞排斥反应和移植物/患者生存后原位肝移植（奥尔特）的影响。方法：1988年10月至1996年12月，325例患者接受环孢霉素为基础的奥尔特在我们的中心。前瞻性调查CMV感染，定义为从血液或尿液中分离出病毒; 53例（16%）患者可检测到CMV。结果：CMV基因型分布为：gB 1型19例（36%），gB 2型15例（28%），gB 3型13例（24%），gB 4型4例（8%）。2例（4%）为混合感染（1+ 3，1+ 4）。不同基因型患者的年龄、术前诊断、更昔洛韦预防、基础免疫抑制、HLA供受者平均错配数和器官共享联合网络状态具有可比性。gB 1患者的平均急性排斥发作次数显著更高（1.52±0.30 vs. 0.67±0.22; P= 0.027）。然而，不同基因型患者的排斥反应严重程度（包括OKT 3使用或FK 506转换）或慢性排斥反应发生率无差异。在15例患者中检测到gB基因型并不影响症状性或组织浸润性CMV疾病的发展。CMV感染组患者生存率（OR 3.0; CI 1.49-6.0）和移植物生存率（OR 2.57; CI 1.25-5.22）均显著低于无CMV感染组（P< 0.0001），但与CMV基因型无关。(1)与无CMV感染的奥尔特受者相比，CMV感染的患者在奥尔特后1年和5年的患者和移植物存活率显著降低。(2)CMV基因型gB 1与较高的平均急性排斥反应次数相关。
Background.The envelope glycoprotein gB of human cytomegalovirus (CMV) occurs as one of four main genotypes. Some previous studies have proposed a relationship of CMV gB genotype to the frequency of symptomatic infection and to clinical outcomes in both transplant and human immunodeficiency virus-infected populations. Our aim was to define the distribution of CMV gB genotypes and the impact on acute cellular rejection and graft/patient survival after orthotopic liver transplantation (OLT).Methods.Between October 1988 and December 1996, 325 patients underwent cyclosporine-based OLT at our center. CMV infection was surveyed prospectively and defined as viral isolation from blood or urine; 53 (16%) patients had detectable CMV. Isolates were genotyped by polymerase chain reaction amplification and restriction digest analysis.Results.The distribution of CMV genotypes was: gB1, 19 (36%) patients; gB2, 15 (28%) patients; gB3, 13 (24%) patients; and gB4, 4 (8%) patients. Two patients (4%) had mixed infection (1+ 3, 1+ 4). Age, preOLT diagnosis, use of ganciclovir prophylaxis, basal immunosuppression, mean number of HLA donor/recipient mismatches, and United Network of Organ Sharing status were comparable among patients with different genotypes. Patients with gB1 had a significantly higher mean number of acute rejection episodes (1.52±0.30 vs. 0.67±0.22; P= 0.027). However, there was no difference in rejection severity, including OKT3 usage or FK506 conversion, or development of chronic rejection among patients with different genotypes. The gB genotype did not affect the development of symptomatic or tissue-invasive CMV disease, detected in 15 patients. Actuarial rates of patient (odds ratio [OR] 3.0; confidence interval [CI] 1.49-6.0) and graft (OR 2.57; CI 1.25-5.22) survival were significantly diminished in the group with CMV infection versus those without CMV (P< 0.0001 for both), but there was no association with CMV genotype.Conclusions.(1) Patients with CMV infection had significantly reduced patient and graft survival rates at 1 and 5 years after OLT as compared with OLT recipients without CMV infection.(2) CMV genotype gB1 was associated with a higher mean number of acute rejection episodes.
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影响因子：
6.2
作者：
Patel, R;Snydman, DR;Paya, CV
通讯作者：
Paya, CV
影响因子：
6.4
作者：
CHOU, SW;DENNISON, KM
通讯作者：
DENNISON, KM
肾移植受者中人巨细胞病毒糖蛋白B基因型
影响因子：
12.7
作者：
C. Vogelberg;U. Meyer;F. Hufert;G. Kirste;D. von Laer
通讯作者：
D. von Laer
影响因子：
3.7
作者：
NAVARRO, D;PAZ, P;PEREIRA, L
通讯作者：
PEREIRA, L
巨细胞病毒血症：丙型肝炎肝移植后同种异体肝硬化的危险因素。
影响因子：
6.2
作者：
H. Rosen;S. Chou;C. Corless;D. Gretch;K. Flora;A. Boudousquie;S. Orloff;J. Rabkin;K. Benner
通讯作者：
K. Benner