Michaels Marian G, Fonseca-Aten Monica, Green Michael, Charsha-May Deborah, Friedman Barry, Seikaly Mouin, Sánchez Pablo J
Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA 15217, USA.
Pediatr Transplant. 2009 Jun;13(4):451-6. doi: 10.1111/j.1399-3046.2008.01017.x. Epub 2008 Sep 10.
RSV can cause respiratory illness after SOT, yet preventive recommendations are lacking for this population. To ascertain current preventive practices against RSV disease in pediatric SOT candidates and recipients, a survey was developed. The survey was mailed to 108 SOT programs in the United States (liver, 42; heart, 28; lung, 11; intestinal, 25; and heart-lung, 2). Results were tabulated and analyzed using standard methods. Sixty-two percent (67/108) of surveys were completed. Forty-nine percent (33/67) of programs reported using RSV prophylaxis; palivizumab was used at 97% (32/33) of centers with 26 giving palivizumab to candidates and 27 to recipients. Prophylaxis was provided to infants aged 0-12 months by 27/29 (93%) of responding centers; 23/29 of centers extended its use to infants aged 0-24 months. Three centers gave prophylaxis to children between ages two and four yr and two centers for those over four yr. RSV prophylactic strategies, and in particular the use of palivizumab, are employed by almost 50% of responding pediatric SOT centers. Strategies varied at centers based on age and organ type. Data on RSV hospitalization and outcome are needed to refine approaches to RSV immunoprophylaxis in these high-risk patients.
呼吸道合胞病毒(RSV)可在实体器官移植(SOT)后引发呼吸道疾病,但针对这一人群缺乏预防性建议。为确定目前针对儿科SOT候选者和接受者预防RSV疾病的做法,开展了一项调查。该调查问卷被邮寄给美国的108个SOT项目(肝脏移植项目42个、心脏移植项目28个、肺移植项目11个、肠道移植项目25个以及心肺联合移植项目2个)。使用标准方法对结果进行列表统计和分析。62%(67/108)的调查问卷被填答。49%(33/67)的项目报告使用了RSV预防措施;97%(32/33)的中心使用了帕利珠单抗,其中26个中心给候选者使用帕利珠单抗,27个中心给接受者使用。27/29(93%)的回复中心为0至12个月大的婴儿提供了预防措施;23/29的中心将其使用范围扩大到了0至24个月大的婴儿。3个中心为2至4岁的儿童提供了预防措施,2个中心为4岁以上的儿童提供了预防措施。近50%的回复儿科SOT中心采用了RSV预防策略,尤其是帕利珠单抗的使用。各中心的策略因年龄和器官类型而异。需要有关RSV住院治疗情况和结果的数据,以完善这些高危患者的RSV免疫预防方法。