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JC 病毒尿症对肾移植恢复和预后的影响。

The impact of JC viruria on renal transplant recovery and prognosis.

机构信息

Department of Urology II, The First Hospital of Jilin University, Changchun, 130011, China.

出版信息

Sci Rep. 2024 Sep 18;14(1):21772. doi: 10.1038/s41598-024-72185-6.

Abstract

Postoperative JC viruria is common in kidney transplant recipients, however there remains a dearth of research on perioperative JCV infection in this population. The clinical significance of JCV monitoring in kidney transplant recipients remains unclear. Based on JCV urine monitoring during the perioperative phase, renal transplant recipients who underwent perioperative and postoperative monitoring at our center were categorized into two groups: the perioperative JC virus infection group and the control group consisting of recipients without detectable JCV DNA in plasma or urine during the two-year follow-up period. A comparative analysis of baseline data was initially performed, followed by a 1:1 propensity score matching of 80 cases from each group. Within the first month after transplantation, the JC viruria group exhibited a significant decrease in the incidence of delayed graft function compared to the control group (P = 0.031).Over the two-year postoperative period, the JC viruria group displayed a significantly lower rate of acute rejection (P = 0.027). Notably, the JC viruria group demonstrated higher estimated glomerular filtration rate levels compared to the control group, particularly within the first year post-transplantation. Moreover, recipient and transplant kidney survival rates did not significantly differ between the two groups (P = 0.642). Perioperative JC viruria in kidney transplant recipients may persist beyond the initial two postoperative years. The presence of JCV is associated with lower rates of DGF and acute rejection, indicating a favorable post-transplant recovery. These findings provide novel insights into the importance of postoperative JCV monitoring.

摘要

肾移植受者术后 JC 病毒尿症较为常见,但关于该人群围手术期 JCV 感染的研究仍较少。肾移植受者 JCV 监测的临床意义尚不清楚。基于围手术期 JCV 尿液监测,本中心对接受围手术期和术后监测的肾移植受者进行分组:围手术期 JCV 感染组和对照组,对照组在两年随访期间,血浆或尿液中均未检测到 JCV DNA。首先对基线数据进行了比较分析,然后对每组 80 例进行了 1:1 的倾向评分匹配。移植后第一个月,JC 病毒尿组的延迟移植物功能障碍发生率明显低于对照组(P=0.031)。术后两年期间,JC 病毒尿组的急性排斥反应发生率明显较低(P=0.027)。值得注意的是,与对照组相比,JC 病毒尿组的估算肾小球滤过率水平更高,尤其是在移植后第一年。此外,两组受者和移植肾的存活率无显著差异(P=0.642)。肾移植受者围手术期 JC 病毒尿可能持续至术后两年以上。JCV 的存在与较低的 DGF 和急性排斥反应率相关,表明移植后恢复良好。这些发现为术后 JCV 监测的重要性提供了新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff6b/11410784/6cb73cb5e8e6/41598_2024_72185_Fig1_HTML.jpg

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