与同种肾移植相关的传染病
INFECTIOUS DISEASES ASSOCIATED WITH RENAL HOMOTRANSPLANTATION.
作者信息
RIFKIND D, MARCHIORO T L, WADDELL W R, STARZL T E
出版信息
JAMA. 1964 Aug 10;189:397-407. doi: 10.1001/jama.1964.03070060007001.
Infectious diseases occurred in 26 of 30 renal homotransplantation patients and contributed to eight of the 12 deaths in this series. There were 52 infections, 17 occurring before and 35 after transplantation. Infections were produced primarily by staphylococci, Pseudomonas species, and the enteric gram-negative bacilli. Staphylococcal infections occurred in 17 of 19 carriers of this organism and in only one of 11 noncarriers. Thirty-three of the 35 postoperative infections followed the intensification of immunosuppressive therapy for treatment of attempted homograft rejection. Granulocytopenia, steroid-induced diabetes, and hypogammaglobulinemia, from suppressive drug therapy, routinely preceded the onset of these complications. The infections, largely of endogenous origin, occurred when the host’s defense mechanisms were depressed.
30例同种肾移植患者中有26例发生了感染性疾病，在该系列的12例死亡病例中有8例与之相关。共有52次感染，其中17次发生在移植前，35次发生在移植后。感染主要由葡萄球菌、假单胞菌属和肠道革兰氏阴性杆菌引起。19例携带该病原体的患者中有17例发生了葡萄球菌感染，而11例非携带者中只有1例发生感染。35例术后感染中有33例是在强化免疫抑制治疗以治疗同种移植排斥反应时发生的。抑制性药物治疗导致的粒细胞减少、类固醇诱导的糖尿病和低丙种球蛋白血症通常在这些并发症发生之前出现。这些感染主要源于内源性感染，在宿主防御机制受到抑制时发生。
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