Morris D J, Longson M, Poslethwaite R J, Mallick N P, Johnson R W
Department of Virology, Booth Hall Children's Hospital, Manchester, U.K.
Q J Med. 1990 Nov;77(283):1165-73. doi: 10.1093/qjmed/77.2.1165.
We attempted to assess the importance of blood transfusion, donor seropositivity, and prednisolone therapy as risk factors for cytomegalovirus infection in cyclosporin-treated renal allograft recipients. Primary infection was diagnosed in 27 of 86 patients (31 per cent) and recurrent infection in 27 of 79 patients (34 per cent). Receipt of banked blood from unselected donors after transplantation did not increase the incidence of primary infection in the few transfused patients. Kidney donor seropositivity and maintenance prednisolone in addition to cyclosporin were associated with increases in the incidence of primary or recurrent infection, respectively. Cytomegalovirus infection was clinically mild. Presumed bacterial pneumonias occurred in three patients with recurrent cytomegalovirus infection. The absence of severe cytomegalovirus disease probably reflected the minimal use of prednisolone. Matching of seronegative donors with seronegative recipients seemed unjustifiable in cyclosporin-treated renal transplant patients.
我们试图评估输血、供体血清反应阳性以及泼尼松龙治疗作为环孢素治疗的肾移植受者巨细胞病毒感染风险因素的重要性。86例患者中有27例（31%）诊断为原发性感染，79例患者中有27例（34%）诊断为复发性感染。移植后接受来自未经筛选供体的库存血，在少数输血患者中并未增加原发性感染的发生率。肾供体血清反应阳性以及除环孢素外使用维持剂量的泼尼松龙，分别与原发性或复发性感染发生率的增加相关。巨细胞病毒感染临床症状较轻。3例复发性巨细胞病毒感染患者发生了疑似细菌性肺炎。未出现严重的巨细胞病毒疾病可能反映了泼尼松龙的使用极少。在环孢素治疗的肾移植患者中，血清反应阴性的供体与血清反应阴性的受体进行匹配似乎并无必要。
