肝移植后巨细胞病毒病：一项基于全国人群的研究。

Cytomegalovirus disease after liver transplantation: a nationwide population-based study.

作者信息

Liu P-Y, Cheng S-B, Lin C-C, Lin C-H, Chang S-N, Cheng C-Y, Shi Z-Y, Tung K-C, Wu M-J

机构信息

Division of Infection, Liver Transplantation Center, Taichung Veterans General Hospital, Taiwan; College of Veterinary Medicine, National Chung Hsing University, Taiwan; Department of Pharmacy, Tajen University, Taiwan.

Department of Surgery, Taichung Veterans General Hospital, Taiwan.

出版信息

Transplant Proc. 2014 Apr;46(3):832-4. doi: 10.1016/j.transproceed.2013.12.009.

DOI:10.1016/j.transproceed.2013.12.009

PMID:24767359

Abstract

BACKGROUND

Cytomegalovirus (CMV) disease is a significant complication after liver transplantation. The estimated incidence varies among studies, which have been conducted in single regional centers and with small cohorts. In this study, we investigated the occurrence of CMV disease among liver transplant recipients in a national cohort in Taiwan.

METHODS

This retrospective study used data from the Taiwan National Health Insurance Research Database. All liver transplant recipients in the catastrophic illness database from 2000 to 2009 were enrolled. Cases of CMV disease were identified from the admission database with the use of the ICD-9-CM code 078.

RESULTS

The national cohort consisted of 1,721 liver transplant recipients (1,200 men and 521 women) with a mean age of 43.9 ± 8.9 years at the time of transplantation. The mean follow-up duration was 3.6 ± 2.7 years. The mortality rate was 14.9% at 1 year and 20.5% at 5 years. During the study period, 84 patients (4.9%) were diagnosed with CMV disease. The overall prevalence of CMV disease was 14.5 per 100 person-years. The cumulative incidences of post-transplantation CMV infection at 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were 1.2%, 2.7%, 3.8%, 4.2%, 4.8%, and 4.9%, respectively. The most common CMV-related diseases were colitis, hepatitis, and pneumonia.

CONCLUSIONS

The risk of CMV disease was significantly elevated in the first 6 months after liver transplantation in the Taiwanese cohort.

摘要

背景

巨细胞病毒（CMV）疾病是肝移植后的一种重要并发症。在单区域中心开展的针对小队列的研究中，CMV疾病的估计发病率各有不同。在本研究中，我们调查了台湾全国队列中肝移植受者CMV疾病的发生情况。

方法

这项回顾性研究使用了台湾国民健康保险研究数据库中的数据。纳入了2000年至2009年重大疾病数据库中的所有肝移植受者。通过使用国际疾病分类第九版临床修正版（ICD - 9 - CM）编码078，从入院数据库中识别出CMV疾病病例。

结果

全国队列由1721名肝移植受者组成（男性1200名，女性521名），移植时的平均年龄为43.9±8.9岁。平均随访时间为3.6±2.7年。1年时的死亡率为14.9%，5年时为20.5%。在研究期间，84名患者（4.9%）被诊断为CMV疾病。CMV疾病的总体患病率为每100人年14.5例。移植后3个月、6个月、1年、2年、5年和10年的CMV感染累积发病率分别为1.2%、2.7%、3.8%、4.2%、4.8%和4.9%。最常见的CMV相关疾病是结肠炎、肝炎和肺炎。