Fryd D S, Peterson P K, Ferguson R M, Simmons R L, Balfour H H, Najarian J S
Transplantation. 1980 Dec;30(6):436-9. doi: 10.1097/00007890-198012000-00010.
A prospective study of 276 patients that were greater than 12 years old and received transplants between October 1, 1977 and September 30, 1979 has been undertaken. Any patient with clinical findings compatible with overt cytomegalovirus (CMV) disease was placed on a "CMV disease diagnostic protocol." All diagnosed cases of CMV occurring before November 15, 1979 have been analyzed. Eighty patients (29%) had overt CMV disease. Seventy-two (90%) of them contracted CMV within the first 3 months post-transplant. The incidence of overt CMV varied with donor type. Eight percent (4 of 49), 17% (8 of 48), 20% (5 of 25), 40% (46 of 115) and 43% (15 of 35) of HLA-identical (ID) siblings, non-ID siblings, child donor, cadaveric donor, and parental donor, respectively, contracted CMV disease. Overt clinical CMV disease influenced the graft function and patient survival rates significantly (P < 0.01). Several risk factors have been considered as possible indicators of CMV disease. These include age, sex, diabetic status, time of onset of CMV, donor and recipient CMV complement-fixing (CF) and indirect fluorescence (IF) titers. The same variables were analyzed to determine whether they might also predict the severity of the disease. Donor CF is the single most important risk factor. Recipient serology alone was not found to be a significant risk factor but 15 of 27 (56%) persons who had a negative titer and received a kidney from a donor with a positive CF titer contracted overt CMV. Nine of those 15 (60%) had moderate, severe, or lethal illness.
对1977年10月1日至1979年9月30日期间接受移植且年龄大于12岁的276例患者进行了一项前瞻性研究。任何有与显性巨细胞病毒（CMV）疾病相符的临床表现的患者都被纳入“CMV疾病诊断方案”。对1979年11月15日前诊断出的所有CMV病例进行了分析。80例患者（29%）患有显性CMV疾病。其中72例（90%）在移植后的前3个月内感染了CMV。显性CMV的发病率因供体类型而异。HLA相同（ID）的同胞、非ID同胞、儿童供体、尸体供体和父母供体中，分别有8%（49例中的4例）、17%（48例中的8例）、20%（25例中的5例）、40%（115例中的46例）和43%（35例中的15例）感染了CMV疾病。显性临床CMV疾病对移植功能和患者生存率有显著影响（P<0.01）。几种危险因素被认为可能是CMV疾病的指标。这些因素包括年龄、性别、糖尿病状态、CMV发病时间、供体和受体的CMV补体结合（CF）及间接荧光（IF）滴度。对相同变量进行分析以确定它们是否也能预测疾病的严重程度。供体CF是唯一最重要的危险因素。单独的受体血清学未被发现是一个显著的危险因素，但27例滴度为阴性且接受了CF滴度为阳性的供体肾脏的患者中有15例（56%）感染了显性CMV。这15例患者中有9例（60%）患有中度、重度或致命疾病。
