Fisher R A
VCU Department of Surgery, Division of Transplantation Surgery, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
Transpl Infect Dis. 2009 Jun;11(3):195-202. doi: 10.1111/j.1399-3062.2009.00372.x. Epub 2009 Feb 18.
As the most prevalent pathogen among transplant patients, cytomegalovirus (CMV) affects up to three-quarters of all solid organ transplant recipients. While we have made great strides in preventing CMV infection and disease in the early post-transplant period, late CMV infection and indirect effects due to viral immunomodulation remain problematic. Changing immunosuppression practices, including the increasing use of T-cell depleting induction antibodies, have the potential to affect the risk for CMV infection and disease, even in the face of good prophylactic and preemptive therapy. The purpose of this review article is to discuss the impact of CMV infection on long-term allograft outcomes and to re-evaluate the risks and management strategies for prevention of CMV in the framework of evolving modern immunosuppressive strategies.
作为移植患者中最常见的病原体，巨细胞病毒（CMV）影响着多达四分之三的实体器官移植受者。虽然我们在预防移植后早期的CMV感染和疾病方面取得了巨大进展，但晚期CMV感染以及病毒免疫调节引起的间接影响仍然存在问题。免疫抑制方案的改变，包括越来越多地使用耗竭T细胞的诱导抗体，即使在有良好的预防性和抢先性治疗的情况下，也有可能影响CMV感染和疾病的风险。这篇综述文章的目的是讨论CMV感染对长期移植物结局的影响，并在不断发展的现代免疫抑制策略框架内重新评估预防CMV的风险和管理策略。
