Humar Atul, Kumar Deepali, Mazzulli Tony, Razonable Raymund R, Moussa George, Paya Carlos V, Covington Emma, Alecock Emma, Pescovitz Mark D
University of Toronto, Toronto, Ontario, Canada.
Am J Transplant. 2005 Oct;5(10):2555-9. doi: 10.1111/j.1600-6143.2005.01033.x.
Little is known about adenovirus infections in adult organ transplant recipients. We prospectively assessed adenovirus infection in 263 transplant recipients using polymerase chain reaction (PCR) on plasma samples at regular intervals post-transplant. Adenovirus DNA was detected in 19 of 263 patients (7.2%). Viremia by transplant type was: liver (n = 10 of 121 [8.3%]), kidney (n = 6 of 92 [6.5%]) and heart (n = 3 of 45 [6.7%]). Time to viremia onset was within 10 days post-transplant (n = 4), on day 28 (n = 1), on day 100 (n = 7) and between months 6 and 12 (n = 7). At the time of viremia, 11 of 19 (58%) patients had no symptoms, 2 of 19 (10.5%) had gastrointestinal (GI) symptoms, 2 of 19 (10.5%) had respiratory symptoms and 4 patients (21%) had vague/non-specific symptoms. All patients recovered spontaneously. Only 1 of 19 (5%) patients had subsequent acute rejection. Adenovirus viremia is relatively common in adult liver, kidney and heart transplant recipients and most infections are asymptomatic, transient and self-limited. No serious clinical sequelae or effects on subsequent acute rejection were observed.
关于成年器官移植受者的腺病毒感染,人们了解甚少。我们对263名移植受者进行了前瞻性评估,在移植后定期采集血浆样本,使用聚合酶链反应(PCR)检测腺病毒感染情况。263名患者中有19名(7.2%)检测到腺病毒DNA。按移植类型划分的病毒血症情况如下:肝脏移植(121例中的10例[8.3%])、肾脏移植(92例中的6例[6.5%])和心脏移植(45例中的3例[6.7%])。病毒血症开始时间为移植后10天内(4例)、第28天(1例)、第100天(7例)以及6至12个月之间(7例)。在出现病毒血症时,19名患者中有11名(58%)无症状,19名中有2名(10.5%)有胃肠道(GI)症状,19名中有2名(10.5%)有呼吸道症状,4名患者(21%)有模糊/非特异性症状。所有患者均自发康复。19名患者中只有1名(5%)随后发生急性排斥反应。腺病毒血症在成年肝脏、肾脏和心脏移植受者中相对常见,大多数感染无症状、短暂且自限性。未观察到严重的临床后遗症或对随后急性排斥反应的影响。