从丙型肝炎病毒血症供体向非病毒血症受者进行肾移植，以及移植后 BK 和巨细胞病毒感染的风险。

Kidney transplant from hepatitis C viremic donors into aviremic recipients and risk for post-transplant BK and cytomegalovirus infection.

机构信息

Division of Nephrology, Kidney and Pancreas Transplant Program, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.

Department of Internal Medicine, Division of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

出版信息

Transpl Infect Dis. 2022 Aug;24(4):e13887. doi: 10.1111/tid.13887. Epub 2022 Jul 13.

DOI:10.1111/tid.13887

PMID:35752929

Abstract

BACKGROUND

kidney transplantation from Hepatitis C virus (HCV) viremic donors to uninfected recipients is associated with excellent short-term outcomes. However, HCV viremia might be associated with an increased risk for post-transplant viral complications.

METHODS

We designed a retrospective study of HCV-negative kidney-only transplant recipients between 2018 and 2020. Recipients were grouped into group 1; HCV-negative donors, and group 2; HCV-viremic donors. Patients were matched 1:1 using propensity score. The primary objectives were to compare the incidence of cytomegalovirus (CMV) viremia ≥ 200 ml/IU, and BK viremia ≥1000 copies/ml between the groups. Secondary outcomes included group comparison of CMV disease, BK viremia ≥10 000 copies/ml, and 1-year patient and allograft survival.

RESULTS

The study included 634 patients in group 1, and 71 patients in group 2. Sixty-five pairs of patients were matched. Incidence of CMV viremia (33.3% vs. 40.0%, p = .4675), and BK viremia (15.9% vs. 27.7%, p = .1353) did not differ significantly between groups in the matched cohort. Incidence of CMV disease (81.0% vs. 76.9%, p = 1.000), and BK viremia ≥10 000 copies/ml (9.5% vs. 16.9%, p = .2987) were comparable between groups. There was no difference in the 1-year patient or allograft survival between groups.

CONCLUSION

kidney transplant from HCV-viremic donors is not associated with increased risk for BK or CMV viremia.

摘要

背景

从丙型肝炎病毒 (HCV) 病毒血症供体向未感染受者移植肾脏与极佳的短期结果相关。然而，HCV 病毒血症可能与移植后病毒并发症的风险增加相关。

方法

我们设计了一项 2018 年至 2020 年间 HCV 阴性的单纯肾脏移植受者的回顾性研究。受者分为组 1；HCV 阴性供者和组 2；HCV 病毒血症供者。使用倾向评分进行 1:1 配对。主要目的是比较两组间巨细胞病毒 (CMV) 血症≥200ml/IU 和 BK 血症≥1000 拷贝/ml 的发生率。次要结局包括两组间 CMV 疾病、BK 血症≥10000 拷贝/ml 和 1 年患者和移植物存活率的比较。

结果

该研究纳入了组 1 的 634 例患者和组 2 的 71 例患者。65 对患者进行了配对。匹配队列中，CMV 血症（33.3% vs. 40.0%，p =.4675）和 BK 血症（15.9% vs. 27.7%，p =.1353）的发生率在两组间无显著差异。CMV 疾病的发生率（81.0% vs. 76.9%，p = 1.000）和 BK 血症≥10000 拷贝/ml 的发生率（9.5% vs. 16.9%，p =.2987）在两组间相当。两组间 1 年患者和移植物存活率无差异。