Stratta R J, Shaeffer M S, Markin R S, Wood R P, Langnas A N, Reed E C, Donovan J P, Woods G L, Bradshaw K A, Pillen T J
Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280.
Dig Dis Sci. 1992 May;37(5):673-88. doi: 10.1007/BF01296422.
Cytomegalovirus is the single most important pathogen in clinical transplantation. Although much progress has been made in our understanding of the molecular biology and epidemiology of CMV infection and in our ability to diagnosis and treat CMV disease, it remains a major cause of morbidity but is no longer a major cause of mortality after liver transplantation. Risk factors for CMV disease after liver transplantation include donor and recipient serologic status, the use of antilymphocyte therapy, and retransplantation. CMV disease occurs early after transplantation, and the most frequent site of disease is the hepatic allograft. We have treated 79 patients with intravenous ganciclovir, with ultimate control of disease achieved in 69 patients (87.3%). Preliminary results using intravenous immunoglobulin and oral acyclovir for CMV prophylaxis in high-risk patients have been encouraging. In addition to producing clinical syndromes. CMV may have direct immunologic effects and is a marker of the net state of immunosuppression.
巨细胞病毒是临床移植中最重要的单一病原体。尽管我们对巨细胞病毒感染的分子生物学和流行病学的理解以及对巨细胞病毒疾病的诊断和治疗能力已取得很大进展，但它仍是发病的主要原因，不过在肝移植后已不再是死亡的主要原因。肝移植后发生巨细胞病毒疾病的危险因素包括供体和受体的血清学状态、抗淋巴细胞疗法的使用以及再次移植。巨细胞病毒疾病在移植后早期发生，最常见的发病部位是肝脏同种异体移植物。我们用静脉注射更昔洛韦治疗了79例患者，其中69例（87.3%）最终疾病得到控制。在高危患者中使用静脉注射免疫球蛋白和口服阿昔洛韦进行巨细胞病毒预防的初步结果令人鼓舞。除了产生临床综合征外，巨细胞病毒可能具有直接的免疫效应，并且是免疫抑制净状态的一个指标。
