Polyomavirus disease in renal transplantation - Review of pathological findings and diagnostic methods
Polyomavirus disease in renal transplantation - Review of pathological findings and diagnostic methods
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DOI：
10.1016/j.humpath.2005.08.009
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发表时间：
2005-12-01
期刊：
影响因子：
3.3
通讯作者：
Papadimitriou, JC
中科院分区：
文献类型：
--
作者：
Drachenberg, CB;Hirsch, HH;Papadimitriou, JC
高达10%的肾移植受者可在同种异体移植物中发生多瘤病毒肾病（PVN），导致移植物过早衰竭。最近的研究表明，在对肾脏造成不可逆损害之前对PVN进行早期诊断，可以显著改善大部分患者的结局，并解决感染问题。早期组织病理学诊断是复杂的感染的微妙开始和它的多灶性。本综述提出了一套全面的指导方针，有效的临床使用尿细胞学和定量的病毒尿和病毒血症结合肾活检的结果。PVN的形态学特征与PVN的模式，是基于疾病的组织学进展，并与临床结果的具体重点。在其临床意义的背景下，还讨论了BK，JC和SV 40多瘤病毒感染的主要病毒学和流行病学方面。(c)2005年爱思唯尔公司All rights reserved.
Up to 10% of renal transplant recipients can develop polyomavirus nephropathy (PVN) in the allograft, leading to premature graft failure. Recent studies have shown that early diagnosis of PVN before there is irreversible damage to the kidney can result in marked improvement of outcome with resolution of the infection in a large proportion of patients. Early histopathologic diagnosis is complicated by the subtle beginning of the infection and its multifocal nature. This review presents a comprehensive set of guidelines for the effective clinical use of urine cytology and quantitation of viruria and viremia in conjunction with the renal biopsy findings. The morphological features of PVN are presented with specific emphasis on the patterns of PVN that are based on the histological progression of the disease and that correlate with clinical outcome. Also discussed in the context of their clinical significance are the main virological and epidemiological aspects of the BK, JC, and SV40 polyomavirus infections. (c) 2005 Elsevier Inc. All rights reserved.