Gorensek M J, Carey W D, Vogt D, Goormastic M
Department of Infectious Disease, Cleveland Clinic Foundation, Ohio.
Gastroenterology. 1990 May;98(5 Pt 1):1326-32. doi: 10.1016/0016-5085(90)90352-2.
Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.
在37个月的时间里，对33例连续的肝移植受者进行了前瞻性研究，以寻找巨细胞病毒感染的证据。共发现16例（48%）巨细胞病毒感染；9例为原发性感染，7例为复发性感染。从第8例患者开始，大多数患者常规给予γ-球蛋白预防治疗。评估了12个巨细胞病毒感染的潜在危险因素，包括供体和受体移植前的巨细胞病毒血清学状态；受体的年龄、性别、种族和肝病；输注血液制品的数量和类型；免疫抑制的类型和强度；以及排斥反应的发生情况。Cox比例风险模型确定，无论受体的巨细胞病毒血清学状态如何，供体巨细胞病毒血清学阳性是随后发生巨细胞病毒感染的唯一最重要危险因素。此外，使用γ-球蛋白预防似乎对播散性巨细胞病毒病的发生有保护作用。
