Balfour H H, Slade M S, Kalis J M, Howard R J, Simmons R L, Najarian J S
Surgery. 1977 May;81(5):487-92.
The majority of renal allograft recipients develop viral infections, usually with cytomegalovirus (CMV). Their source if virus has not been defined clearly; one possibility if the transplanted kidney itself. To explore this, prospective viral studies were performed on 28 living related donor-recipient pairs. Donors did not have clinical illnesses and viruses were not recovered from throat, urine, or renal tissue, but five (18%) had fourfold rises in antibody titers to herpes group viruses. During the 6 months after transplantation, 24 recipients (86%) had viral infections, 18 of which were associated with CMV. There was no correlation between specific titer rises in the donors and infections in the recipients. Recipients with dual viral infections had more severe clinical courses than those with single infections or with no infection. Recipients with complement-fixing (CF) antibodies to CMV pretransplant had a higher incidence of CMV infections than recipients without pretransplant antibody. Three of seven recipients who lacked CF antibody to CMV and whose donors were seropositive developed clinical illnesses associated with CMV. Latent virus might have been transmitted with the transplanted kidney in these instances, but since lack of CF antibody does not rule out previous CMV infection, the CMV could have been of recipient origin. We conclude that the donor organ is a source of virus for few renal transplant recipients.
大多数肾移植受者会发生病毒感染，通常是感染巨细胞病毒（CMV）。病毒的来源尚未明确界定；一种可能性是移植的肾脏本身。为了探究这一点，对28对活体亲属供受者进行了前瞻性病毒学研究。供者没有临床疾病，咽喉、尿液或肾组织中也未检测到病毒，但有5名供者（18%）针对疱疹病毒组的抗体滴度出现了四倍增长。在移植后的6个月内，24名受者（86%）发生了病毒感染，其中18例与CMV有关。供者特定抗体滴度的升高与受者感染之间没有相关性。发生双重病毒感染的受者临床病程比单一感染或未感染的受者更为严重。移植前对CMV有补体结合（CF）抗体的受者发生CMV感染的发生率高于移植前无抗体的受者。7名对CMV缺乏CF抗体且供者血清学呈阳性的受者中有3人出现了与CMV相关的临床疾病。在这些情况下，潜伏病毒可能随移植肾一同传播，但由于缺乏CF抗体并不排除先前存在CMV感染，因此CMV也可能来源于受者。我们得出结论，供者器官只是少数肾移植受者病毒的来源。
