Donor and recipient CMV serostatus and antigenemia after renal transplantation: An analysis of 486 patients
Donor and recipient CMV serostatus and antigenemia after renal transplantation: An analysis of 486 patients
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DOI：
10.1016/j.jcv.2007.10.006
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发表时间：
2008-02-01
影响因子：
8.8
通讯作者：
Klenerman, Paul
中科院分区：
文献类型：
--
作者：
Hughes, David;Hafferty, John;Klenerman, Paul
背景：肾移植受者的巨细胞病毒感染是一个主要的临床问题，有短期和长期的后遗症。感染可能是潜伏病毒重新激活或来自捐赠者组织的新感染的结果。供者和受者的血清状态对病毒血症的影响已得到很好的认识，血清阴性的受者在从血清阳性的捐赠者身上移植器官后风险最大。然而，将这些器官移植到血清阳性的受者身上的影响还不是很清楚。目的：评估受者血清状态对大型肾移植队列中CMV抗原血症风险的影响。研究设计：我们前瞻性地量化了486名受者随时间推移的CMV抗原血症。我们根据供者和受者的血清状态分析抗原血症的状态。结果：抗原血症最常见于血清阴性的供者器官的受者(D+/R-)。然而，我们观察到，即使在巨细胞病毒血清阳性的受者中，供者血清状态对巨细胞病毒抗原血症的影响仍然很大(p=0.006；OR=2.2)。结论：在这项大型研究中，供者血清状态显然在确定巨细胞病毒风险方面起着重要作用，即使在血清阳性的受者中也是如此。(C)2007 Elsevier B.V.保留所有权利。
Background: Cytomegalovirus infection in renal transplant recipients is a major clinical problem, with both short and long term sequelae. Infection can occur as a result of reactivation of latent virus or new infection from donor tissues. The impact of donor and recipient serostatus on viremia is well recognised, with seronegative recipients at greatest risk after transplantation of an organ from a seropositive donor. However, the impact of grafting such organs into seropositive recipients is less clear.Objectives: To assess the impact of recipient serostatus on the risk of CMV antigenemia in a large renal transplant cohort.Study design: We prospectively quantified CMV antigenemia over time in a cohort of 486 recipients. We analysed the antigenemia status according to donor and recipient serostatus.Results: Antigenemia was most common in seronegative recipients of organs from seropositive donors (D+/R-). Nevertheless, we observed that even in CMV seropositive recipients, the impact of donor serostatus on CMV antigenemia is still substantial (p = 0.006; OR = 2.2).Conclusions: In this large study, donor serostatus clearly plays a significant role in determining CMV risk, even in seropositive recipients. (c) 2007 Elsevier B.V. All rights reserved.