原位肝移植中的巨细胞病毒感染
Cytomegalovirus infection in orthotopic liver transplantation.
作者信息
Sayage L H, Gonwa T A, Goldstein R M, Husberg B S, Klintmalm G B
机构信息
Department of Surgery, Baylor University Medical Center, Dallas, TX 75246.
出版信息
Transpl Int. 1989 Aug;2(2):96-101. doi: 10.1007/BF02459327.
We retrospectively studied 175 orthotopic liver transplants in 151 patients. Of the 151 patients, 59 (39.1%) were diagnosed as having cytomegalovirus (CMV) infection. The rate of infection in patients treated for rejection was 48.8% as compared to 26.2% in patients without rejection (P less than 0.01). Antirejection therapy was associated with culture-positive cases in 33 out of 43 patients as compared to 9 out of 16 patients who had CMV antibody titer elevations. Patients were treated with gancyclovir if they had simultaneous positive cultures from multiple sites and were seriously ill. Eighteen of the 19 patients thus treated had side effects, one of which was serious (bone marrow hypoplasia). Cultures became negative in 15 out of 17 (88%) of the surviving patients. Patient survival was similar to our overall survival rate of 87%.
我们回顾性研究了151例患者的175例原位肝移植。在这151例患者中，59例（39.1%）被诊断为巨细胞病毒（CMV）感染。接受抗排斥治疗的患者感染率为48.8%，而未接受抗排斥治疗的患者感染率为26.2%（P<0.01）。43例接受抗排斥治疗的患者中有33例出现培养阳性病例，而16例巨细胞病毒抗体滴度升高的患者中有9例出现培养阳性病例。如果患者多个部位培养同时呈阳性且病情严重，则接受更昔洛韦治疗。接受治疗的19例患者中有18例出现副作用，其中1例严重（骨髓发育不全）。17例存活患者中有15例（88%）培养结果转为阴性。患者生存率与我们87%的总体生存率相似。
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