González-Pérez M Paz, Muñoz-Juárez Lourdes, Cárdenas Francisca Cárdenas, Zarranz Imirizaldu Juan J, Carranceja Jesús Corral, García-Saiz Alfredo
Diagnóstico y Referencia de Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Pozuelo-Majadahonda, km 2, 28220 Madrid, Spain.
Transplantation. 2003 Apr 15;75(7):1006-11. doi: 10.1097/01.TP.0000058470.15921.CA.
The human T-cell lymphotrophic virus (HTLV) causes adult T-cell leukemia-lymphoma, tropical spastic paraparesis-HTLV type I, and associated myelopathy.
An analysis was performed of serum samples from a multiorgan donor and the five recipients. Also studied was the donor's family and the partner of one of the renal recipients. Serologic detection of anti-HTLV antibodies was carried out by enzyme immunoassay and Western blot to confirm and discriminate between HTLV types. Analysis of proviral DNA was performed by polymerase chain reaction and sequenced in the long terminal repeat region and the env gene. Peripheral blood mononuclear cell samples from all the recipients of the HTLV-I-positive organs and the donor's mother were studied.
Two years after transplantation, three organ recipients positive for antibodies to HTLV-I were detected (two kidney transplants and one liver). All the recipients' serum samples were negative at the time of transplantation except those from the multiorgan donor. The donor's mother was born in Venezuela and was confirmed positive for antibodies to HTLV-I. The remaining family members were negative. HTLV-I DNA sequences were recovered, amplified, and sequenced from all the samples from the HTLV-I-positive recipients and the donor's mother. The homology of HTLV-I sequences was 100% in all cases.
The authors are reporting the first documented case of HTLV-I infection in several transplant recipients sharing the same donor. The donor was infected by vertical transmission. HTLV-I infection has devastating consequences for some immunocompromised organ recipients. This emphasizes the need for a systematic survey of HTLV antibodies in all potential donors.
人类嗜T细胞病毒（HTLV）可引发成人T细胞白血病-淋巴瘤、I型热带痉挛性截瘫- HTLV及相关脊髓病。
对一名多器官供体和五名受体的血清样本进行了分析。还对供体的家属以及一名肾移植受体的伴侣进行了研究。通过酶免疫测定法和蛋白质印迹法进行抗HTLV抗体的血清学检测，以确认并区分HTLV的类型。通过聚合酶链反应进行前病毒DNA分析，并在长末端重复区域和env基因中进行测序。对所有HTLV-I阳性器官受体和供体母亲的外周血单个核细胞样本进行了研究。
移植两年后，检测到三名HTLV-I抗体阳性的器官受体（两例肾移植和一例肝移植）。除多器官供体的样本外，所有受体的血清样本在移植时均为阴性。供体的母亲出生于委内瑞拉，被确认为HTLV-I抗体阳性。其余家庭成员均为阴性。从HTLV-I阳性受体和供体母亲的所有样本中回收、扩增并测序了HTLV-I DNA序列。所有病例中HTLV-I序列的同源性均为100%。
作者报告了首例记录在案的同一供体的多名移植受体感染HTLV-I的病例。供体是通过垂直传播感染的。HTLV-I感染对一些免疫功能低下的器官受体具有毁灭性后果。这强调了对所有潜在供体进行HTLV抗体系统检测的必要性。
