Milan A, Sampaio A M, Guardia A C, Pavan C R, Andrade P D, Bonon S H A, Costa S C B, Ataíde E, Boin I F S F, Stucchi R S B
Faculty of Medical Science, Liver Transplantation Unit, State University of Campinas, Campinas, Brazil.
Transplant Proc. 2011 May;43(4):1360-1. doi: 10.1016/j.transproceed.2011.02.031.
Cytomegalovirus (CMV) is a β-herpesvirus. CMV infections are a common complication contributing to morbidity and mortality after liver transplantation. Among organ transplant recipients, CMV can reactivate from latency during the first 6 months. This prospective study performed from February 2008 to December 2009 examined liver transplant recipients during the first 6 months. Two methods were performed to detect CMV infections: antigenemia (AGM) and nested (PCR). Ninety-four patients, including 72 men (76.6%) and 22 women (23.4%) underwent liver transplantation during this period. We analyzed 575 samples including 465 for AGM and PCR. Forty-three (9.25%) showed positive AGM as detected 2 to 179 days posttransplantation with a mean of 50 days and a median of 35 days, and 93/465 (20%) showed positive PCR at 0 to 186 days posttransplantation with a mean of 31 days and a median of 38 days. Among the 43 antigenemia patients, 38 samples were positive for up to 5 cells 18 of which were PCR-positive. Five samples were positive with more than 5 cells, including 3 that were PCR-positive. Only 4.51% had AGM and were PCR-positive in the same sample. Despite only 9.25% (43/465) showing AGM, the current study suggested the utility of routine monitoring to detect early CMV infection among liver transplantation patients seeking to reduce morbidity and mortality.
巨细胞病毒（CMV）是一种β疱疹病毒。CMV感染是肝移植后导致发病和死亡的常见并发症。在器官移植受者中，CMV可在头6个月内从潜伏状态重新激活。这项于2008年2月至2009年12月进行的前瞻性研究，在头6个月内对肝移植受者进行了检查。采用两种方法检测CMV感染：抗原血症（AGM）和巢式聚合酶链反应（PCR）。在此期间，94例患者接受了肝移植，其中包括72名男性（76.6%）和22名女性（23.4%）。我们分析了575份样本，其中465份用于AGM和PCR检测。43份（9.25%）在移植后2至179天检测出AGM阳性，平均为50天，中位数为35天；93/465（20%）在移植后0至186天PCR检测呈阳性，平均为31天，中位数为38天。在43例抗原血症患者中，38份样本每5个细胞中检测出阳性，其中18份PCR检测呈阳性。5份样本每5个细胞以上检测出阳性，其中3份PCR检测呈阳性。同一样本中AGM和PCR均呈阳性的仅占4.51%。尽管只有9.25%（43/465）的样本显示AGM阳性，但本研究表明，对于试图降低发病率和死亡率的肝移植患者，常规监测对于检测早期CMV感染是有用的。
