Ho M, Suwansirikul S, Dowling J N, Youngblood L A, Armstrong J A
N Engl J Med. 1975 Nov 27;293(22):1109-12. doi: 10.1056/NEJM197511272932201.
To determine the incidence of cytomegalovirus infection in renal-transplant recipients we followed 32 prospectively for six months after operation. As judged by serologic change and virus isolation the infection rate for the entire group was 66 per cent (21 of 32 patients) - 59 per cent (13 of 22) for seronegative patients and 80 per cent (eight of 10) for seropositive patients. Of 10 seronegative patients who received kidneys from seronegative donors, only three became infected. However, of 12 seronegative patients who received kidneys from seropositive donors, 10 became infected. Thus, there was a significant correlation between development of infection and seropositivity of the donor (P = 0.03), particularly when the recipient was seronegative (P = 0.02). Five possible and four definite recognizable clinical illnesses were associated with cytomegalovirus infection; all except two were in initially seronegative subjects who received kidneys from seropositive donors. Primary infection and disease in nonimmune recipients may be caused by cytomegalovirus transmitted by the kidneys of latently infected seropositive donors.
为了确定肾移植受者中巨细胞病毒感染的发生率，我们对32例患者进行了前瞻性研究，术后随访6个月。根据血清学变化和病毒分离判断，整个组的感染率为66%（32例患者中的21例）——血清阴性患者为59%（22例中的13例），血清阳性患者为80%（10例中的8例）。在10例接受血清阴性供者肾脏的血清阴性患者中，只有3例被感染。然而，在12例接受血清阳性供者肾脏的血清阴性患者中，有10例被感染。因此，感染的发生与供者的血清阳性之间存在显著相关性（P = 0.03），特别是当受者为血清阴性时（P = 0.02）。5种可能的和4种明确可识别的临床疾病与巨细胞病毒感染有关；除2例之外，所有病例均为最初血清阴性的受者，他们接受了血清阳性供者的肾脏。非免疫受者的原发性感染和疾病可能由潜伏感染的血清阳性供者的肾脏传播的巨细胞病毒引起。
