Kim Wontae, Kim Sangjin, Oh Jongwook, Jeong Young Jae, Rhu Jinsoo, Kim Kyung Sik, Lee Jisoo, Choi Gyu-Sung, Kim Jong Man, Joh Jae-Won
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2019 Feb;96(2):95-99. doi: 10.4174/astr.2019.96.2.95. Epub 2018 Jan 30.
Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus, which occurs frequently in liver transplant recipients with impaired cellular immunity. The purpose of this study was to evaluate the incidence and risk factors for HZ after adult liver transplantation (LT).
In our institution, 993 patients underwent adult LT from January 1997 to December 2013. We retrospectively analyzed the incidence rate of HZ and risk factors for HZ after LT.
Of 993 LT recipients, 101 (10.2%) were diagnosed with HZ. The incidence of HZ at 1, 3, 5, and 10 years was 6.6%, 9.1%, 10.0%, and 11.9%, respectively. Therefore, we observed that the incidence of HZ after LT was 16.3 per 1,000 person-years. Older age (≥50 years) at LT and mycophenolate mofetil (MMF) exposure were independent risk factors of HZ infection after adult LT.
Patients older than 50 years or with MMF exposure are considered to be at high risk for HZ. Therefore, adult liver recipients with such factors should not be given strong immunosuppression treatments.
带状疱疹（HZ）由水痘-带状疱疹病毒再激活引起，在细胞免疫受损的肝移植受者中频繁发生。本研究的目的是评估成人肝移植（LT）后HZ的发生率及危险因素。
在我们机构，1997年1月至2013年12月期间993例患者接受了成人LT。我们回顾性分析了LT后HZ的发生率及危险因素。
993例LT受者中，101例（10.2%）被诊断为HZ。1年、3年、5年和10年时HZ的发生率分别为6.6%、9.1%、10.0%和11.9%。因此，我们观察到LT后HZ的发生率为每1000人年16.3例。LT时年龄较大（≥50岁）和霉酚酸酯（MMF）暴露是成人LT后HZ感染的独立危险因素。
年龄大于50岁或暴露于MMF的患者被认为有发生HZ的高风险。因此，具有这些因素的成人肝移植受者不应给予强效免疫抑制治疗。
