Melero-Ferrer Josep, Sanchez-Lazaro Ignacio J, Navea-Tejerina Amparo, Almenar-Bonet Luis, Blanes-Julia Marino, Martinez-Dolz Luis, Salvador-Sanz Antonio
Unidad de Insuficiencia Cardíaca y Trasplante Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain.
Case Rep Transplant. 2012;2012:305920. doi: 10.1155/2012/305920. Epub 2012 Nov 4.
Infections are one of the leading causes of morbidity and mortality in heart transplantation (HTx). Cytomegalovirus (CMV) is the most common viral infection during the first year after HTx, but it is more unusual after this time. We present the case of a patient who underwent an HTx due to a severe ischemic heart disease. Although the patient did not have a high risk for CMV, infection, he suffered a reactivation during the first year and then up to six more episodes, especially in his eyes. The patient received different treatments against CMV and the immunosuppression was changed several times. Finally, everolimus was introduced instead of cyclosporine, and mycophenolate mofetil was withdrawn. The presented case provides an example of how the immunosupresion plays a key role in some infections in spite of being a suitable antiviral treatment.
感染是心脏移植（HTx）中发病和死亡的主要原因之一。巨细胞病毒（CMV）是HTx后第一年最常见的病毒感染，但在此之后则较为少见。我们报告一例因严重缺血性心脏病接受HTx的患者。尽管该患者发生CMV感染的风险不高，但在第一年出现了病毒再激活，随后又出现了多达六次发作，尤其是眼部发作。患者接受了不同的抗CMV治疗，免疫抑制方案也多次更改。最后，用依维莫司取代了环孢素，并停用了霉酚酸酯。该病例表明，尽管有合适的抗病毒治疗，但免疫抑制在某些感染中仍起着关键作用。
