Paediatric Liver Centre, King's College London School of Medicine, King's College Hospital NHS Foundation Trust, London, UK.
Clin Transplant. 2012 Jan-Feb;26(1):E55-61. doi: 10.1111/j.1399-0012.2011.01535.x. Epub 2011 Oct 10.
The clinical impact of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections in the early post-transplantation period are poorly documented. We investigated the prevalence and timing of EBV and CMV infections during the first 21 d post-transplantation in relation to graft function and acute cellular rejection in a large cohort of pediatric liver transplantation recipients.
Clinical, biochemical, virological, and histopathological data of 62 consecutive children who received a liver transplant were reviewed retrospectively.
Seventeen patients (27%) developed EBV and 11 (18%) CMV viremia (mean interval from surgery: 7.6 d, SD 3.6 and 8.7 d, SD 6.4, respectively). EBV and CMV viremia were more common as a consequence of reactivation than of primary infection. EBV viremic recipients had more often abnormal bilirubin levels [p = 0.01; OR 5.8: 95% CI 1.3-25.5]. Acute rejection was diagnosed in 20 recipients (32.3%). No correlation was found between rejection and EBV and CMV serology before transplantation and viremia after transplantation (mean interval between the diagnosis of rejection and the detection of EBV DNA and CMV DNA: one d, SD 4.4 and five d, SD 9.2, respectively).
EBV and CMV viremia occur at a very early-stage post-transplantation and do not appear to affect the short-term outcome of the transplant.
Epstein-Barr 病毒（EBV）和巨细胞病毒（CMV）在移植后早期的临床影响尚未得到充分证实。我们研究了在 62 例连续接受肝移植的儿童中，在移植后前 21 天内 EBV 和 CMV 感染的流行率和时间与移植物功能和急性细胞排斥反应的关系。
回顾性分析了 62 例连续接受肝移植的儿童的临床、生化、病毒学和组织病理学数据。
17 例（27%）患者发生 EBV 和 11 例（18%）CMV 血症（平均手术间隔时间：7.6 d，SD 3.6 和 8.7 d，SD 6.4）。EBV 和 CMV 血症更常见于再激活而不是原发性感染。 EBV 血症患者的胆红素水平异常更常见（p = 0.01；OR 5.8：95%CI 1.3-25.5）。20 例（32.3%）患者诊断为急性排斥反应。在移植前 EBV 和 CMV 血清学与移植后病毒血症（诊断排斥反应与检测 EBV DNA 和 CMV DNA 之间的平均间隔时间：1 d，SD 4.4 和 5 d，SD 9.2）之间未发现相关性。
EBV 和 CMV 血症发生在移植后非常早期，似乎不会影响移植的短期结果。
