Simmons R L, Matas A J, Rattazzi L C, Balfour H H, Howard J R, Najarian J S
Surgery. 1977 Nov;82(5):537-46.
An ongoing prospective study of the role of viruses in renal transplant recipients has provided identification of two patterns of cytomegalovirus (CMV) infection. In both patterns, fever and leukopenia occur within 6 months after transplant. In addition, the benign form is characterized by renal biopsy evidence of rejection and brisk Antibody responses to CMV. The lethal syndrome runs a typical 4 week course, beginning with prostration, orthostatic hypotension, mild hypoxemia and progressing to severe pulmonary and hepatic dysfunction, muscle wasting, central nervous system depression, and death. antibody responses to CMV are minimal, and renal biopsy does not show rejection despite elevation of serum creatinine. At autopsy, CMV is found in lung, liver, kidney, gastrointestinal tract, and brain. Successful management of the potentially lethal kidney, gastrointestinal tract, and brain. Successful management of the potentially lethal CMV syndrome requires rapid clinical recognition and immediate reduction of immunosuppressive therapy. future prospects for control include development of a CMV vaccine and specific antiviral chemotherapy.
一项关于病毒在肾移植受者中作用的前瞻性研究持续进行，已确定了两种巨细胞病毒（CMV）感染模式。在这两种模式中，发热和白细胞减少均出现在移植后6个月内。此外，良性形式的特征是肾活检有排斥反应的证据以及对CMV的活跃抗体反应。致死综合征病程典型，为期4周，始于极度虚弱、体位性低血压、轻度低氧血症，进而发展为严重的肺和肝功能障碍、肌肉萎缩、中枢神经系统抑制及死亡。对CMV的抗体反应微弱，尽管血清肌酐升高，但肾活检未显示排斥反应。尸检时，在肺、肝、肾、胃肠道和脑内发现CMV。成功处理潜在致命性的CMV综合征需要临床快速识别并立即减少免疫抑制治疗。控制的未来前景包括研发CMV疫苗和特异性抗病毒化疗。
