Gray J, Wreghitt T G, Pavel P, Smyth R L, Parameshwar J, Stewart S, Cary N, Large S, Wallwork J
Department of Clinical Microbiology, Addenbrooke's Hospital, Cambridge, United Kingdom.
J Heart Lung Transplant. 1995 Jul-Aug;14(4):640-6.
A retrospective serologic study was made of 67 heart-lung and 295 heart transplant recipients (with transplantations at Papworth Hospital, Cambridge, England) to determine the incidence and clinical impact of Epstein-Barr virus infection.
Epstein-Barr virus capsid antigen immunofluorescence tests were performed, and the antibody avidity was determined by modifying the washing procedure to include a mild reducing agent (8M urea).
This testing showed that 6.0% of the patients had primary Epstein-Barr virus infections, whereas 17.4% had the reactivation of a past infection. Primary infections were only detected in patients who were Epstein-Barr virus antibody-negative before transplantation, who had received an organ from an Epstein-Barr virus antibody-positive donor. Of the patients with serologically proven Epstein-Barr virus infections, 52.9% had symptoms. Although these were generally mild, five heart and two heart-lung transplant recipients had malignant lymphoma and one heart and one heart-lung transplant recipient had lymphoproliferative disease after Epstein-Barr virus infection. Additional four heart transplant recipients had lymphoma after transplantation. None of these four patients had evidence of active Epstein-Barr virus infection; one was Epstein-Barr virus antibody-negative during the study period and three had stable Epstein-Barr virus virus capsid antigen immunoglobulin G titers throughout.
Epstein-Barr virus infection in organ transplant recipients may lead on to life-threatening lymphoproliferative disease or lymphoma. For this reason it may be beneficial to monitor patients after transplantation for evidence of Epstein-Barr virus infection and to follow the progress of those affected.
对67例心肺移植受者和295例心脏移植受者（在英国剑桥帕普沃思医院接受移植手术）进行了一项回顾性血清学研究，以确定爱泼斯坦-巴尔病毒感染的发生率及其临床影响。
进行了爱泼斯坦-巴尔病毒衣壳抗原免疫荧光检测，并通过修改洗涤程序以加入一种温和的还原剂（8M尿素）来测定抗体亲和力。
该检测显示，6.0%的患者发生了原发性爱泼斯坦-巴尔病毒感染，而17.4%的患者既往感染复发。原发性感染仅在移植前爱泼斯坦-巴尔病毒抗体阴性、接受了来自爱泼斯坦-巴尔病毒抗体阳性供体器官的患者中检测到。在血清学证实有爱泼斯坦-巴尔病毒感染的患者中，52.9%有症状。尽管这些症状通常较轻，但5例心脏移植受者和2例心肺移植受者在爱泼斯坦-巴尔病毒感染后发生了恶性淋巴瘤，1例心脏移植受者和1例心肺移植受者发生了淋巴增殖性疾病。另外4例心脏移植受者在移植后发生了淋巴瘤。这4例患者均无活动性爱泼斯坦-巴尔病毒感染的证据；1例在研究期间为爱泼斯坦-巴尔病毒抗体阴性，3例在整个过程中爱泼斯坦-巴尔病毒衣壳抗原免疫球蛋白G滴度稳定。
器官移植受者的爱泼斯坦-巴尔病毒感染可能导致危及生命的淋巴增殖性疾病或淋巴瘤。因此，移植后监测患者是否有爱泼斯坦-巴尔病毒感染证据并跟踪受影响患者的病情进展可能有益。
