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供者源性细小病毒 B19 感染与肾移植。

Donor-Derived Human Parvovirus B19 Infection in Kidney Transplantation.

机构信息

Kidney Disease Center, the First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.

Kidney Disease Immunology Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, China.

出版信息

Front Cell Infect Microbiol. 2021 Oct 15;11:753970. doi: 10.3389/fcimb.2021.753970. eCollection 2021.

Abstract

BACKGROUND

Donor-derived human parvovirus B19 (B19V) infections are rarely reported. Thus, its incidence in kidney transplantation is still unknown due to lack of surveillance studies. Similarly, whether the donor needs to be routinely screened for B19V and whether the kidneys from those with B19V DNAemia could be accepted also remain unknown.

METHODS

This retrospective study aims to evaluate the donor-derived B19V infections occurring in 823 living and 1,225 deceased donor kidney transplantations from January 2016 to December 2020. The serum viral load of living donors and their corresponding recipients was evaluated before and after transplantation. Meanwhile, for the deceased donor kidney transplantation, the serum viral load of recipients was only tested after transplantation; if recipients of a deceased donor subsequently developed B19V infection, the serum viral load of recipients and their corresponding donors before transplantation would then be further traced.

RESULTS

A total of 15 living donors were B19V DNAemia positive before the donation, of which B19V DNAemia occurred in three corresponding recipients. In deceased donor kidney transplantation, DNAemia occurred simultaneously in 18 recipients and their corresponding nine donors. A progressive decline in hemoglobin and reticulocyte count could be observed in one living donor recipient and other 11 deceased donor recipients, which were all well controlled by treatment eventually.

CONCLUSION

The incidence of donor-derived B19V infection was 0.4% and 1.5% in living and deceased kidney transplantations, respectively. B19V was seemingly unnecessary to be routinely screened for the donor. Moreover, kidneys of the donors with B19V infection were acceptable.

摘要

背景

供体源性人细小病毒 B19(B19V)感染很少见报道。因此,由于缺乏监测研究,其在肾移植中的发病率尚不清楚。同样,是否需要对供体进行常规 B19V 筛查,以及是否可以接受来自 B19V 血症供体的肾脏也不清楚。

方法

本回顾性研究旨在评估 2016 年 1 月至 2020 年 12 月期间 823 例活体和 1225 例尸体供体肾移植中发生的供体源性 B19V 感染。评估活体供体及其相应受者在移植前后的血清病毒载量。同时,对于尸体供体肾移植,仅在移植后检测受者的血清病毒载量;如果尸体供体的受者随后发生 B19V 感染,则进一步追踪受者及其相应供体在移植前的血清病毒载量。

结果

共有 15 例活体供体在捐献前呈 B19V DNA 血症阳性,其中 3 例相应受者发生 B19V DNA 血症。在尸体供体肾移植中,18 例受者及其相应的 9 例供者同时发生 DNA 血症。1 例活体供体受者和其他 11 例尸体供体受者的血红蛋白和网织红细胞计数均出现进行性下降,但最终均通过治疗得到良好控制。

结论

活体和尸体供肾移植中供体源性 B19V 感染的发生率分别为 0.4%和 1.5%。B19V 似乎不需要对供体进行常规筛查。此外,B19V 感染供体的肾脏是可以接受的。

相似文献

1
Donor-Derived Human Parvovirus B19 Infection in Kidney Transplantation.供者源性细小病毒 B19 感染与肾移植。
Front Cell Infect Microbiol. 2021 Oct 15;11:753970. doi: 10.3389/fcimb.2021.753970. eCollection 2021.

本文引用的文献

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Human Parvoviruses.人类细小病毒
Clin Microbiol Rev. 2017 Jan;30(1):43-113. doi: 10.1128/CMR.00040-16.
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Donor-derived infection--the challenge for transplant safety.供体源性感染——移植安全面临的挑战。
Nat Rev Nephrol. 2014 Nov;10(11):663-72. doi: 10.1038/nrneph.2014.159. Epub 2014 Sep 2.
9
Human parvovirus B19 in solid organ transplantation.实体器官移植中的人细小病毒B19
Am J Transplant. 2013 Mar;13 Suppl 4:201-5. doi: 10.1111/ajt.12111.

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