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[相关供体肾移植受者中的耐巨细胞病毒感染]

[Resistant cytomegalovirus infection in related donor kidney allograft recipients].

作者信息

Goryainov V A, Kaabak M M, Babenko N N, Platova E N, Aganesov A G, Morozova M M, Panin V V

机构信息

Acad. B.V. Petrovsky Russian Surgery Research Center, Moscow, Russia.

出版信息

Ter Arkh. 2016;88(6):73-76. doi: 10.17116/terarkh201688673-76.

Abstract

AIM

To clarify whether cytomegalovirus (CMV) infection can affect the results of living related donor kidney transplantation.

SUBJECTS AND METHODS

A study group included 17 (7.27%) patients (10 men and 7 women; 8 children and 9 adults) aged 3 to 51 years who had developed resistant CMV infection. For comparative analysis, a control group was formed from 113 patients (61 men and 52 women; 40 children and 73 adults) aged 1 to 61 years, whose CMV polymerase chain reaction (PCR) had always been negative, i.e. CMV DNA was absent. The duration of CMV infection episodes was 44 to 232 days.

RESULTS

The patients were given valganciclovir in a dose of 450 mg/day. CMV PCR was negative in all the patients at the end of therapy. None of the patients died; one graft was lost. In the control (negative CMV PCR) group, 6 grafts were lost in 113 patients lost and 4 patients died. Statistical analysis showed that the results of related donor kidney transplantation were virtually equal.

CONCLUSION

Suppression of resistant CMV infection can be achieved with the longer use of valganciclovir or its higher dose. CMV infection fails to affect the results of related donor kidney transplantation.

摘要

目的

阐明巨细胞病毒(CMV)感染是否会影响亲属活体供肾移植的结果。

对象与方法

研究组包括17例(7.27%)发生CMV耐药感染的患者(10例男性和7例女性;8例儿童和9例成人),年龄在3至51岁之间。为进行对比分析,对照组由113例患者(61例男性和52例女性;40例儿童和73例成人)组成,年龄在1至61岁之间,其CMV聚合酶链反应(PCR)始终为阴性,即不存在CMV DNA。CMV感染发作的持续时间为44至232天。

结果

患者接受了剂量为450毫克/天的缬更昔洛韦治疗。治疗结束时所有患者的CMV PCR均为阴性。无患者死亡;1例移植肾失功。在对照组(CMV PCR阴性)中,113例患者中有6例移植肾失功,4例患者死亡。统计分析表明,亲属供肾移植的结果基本相同。

结论

长期使用缬更昔洛韦或增加其剂量可抑制CMV耐药感染。CMV感染不会影响亲属供肾移植的结果。

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