Boland G J, Ververs C, Hené R J, Jambroes G, Donckerwolcke R A, de Gast G C
Department of Immuno-Hematology, University Hospital Utrecht, The Netherlands.
Transpl Int. 1993 Jan;6(1):34-8. doi: 10.1007/BF00336637.
A randomized study of prophylaxis with hyperimmune globulin (HIg) was performed in 28 cytomegalovirus (CMV)-seronegative heart and kidney recipients with CMV-seropositive donors who were extensively monitored for active CMV infection and CMV disease. Detection of CMV antigen in peripheral blood granulocytes (antigenemia) was the first sign of primary CMV infection, generally occurring several weeks before IgM or IgG anti-CMV antibodies were detected and before positive cultures appeared. A correlation was found between rejection treatment with OKT3 or ATG, severity of CMV disease, and graft loss. Rejection treatment had no influence on incidence of CMV transmission. Primary CMV infection occurred most often in older patients with older donors. No beneficial effects were seen with HIg prophylaxis, which was administered from week 1 until week 7 after transplantation. Incidence of primary CMV infection was equal in both groups (50%) and no influence on the severity of primary CMV infection was seen. The only effect that was seen was on the time from transplantation to detection of active CMV infection, which was prolonged by HIg prophylaxis.
对28例接受心脏和肾脏移植且供体巨细胞病毒（CMV）血清学阳性、受体CMV血清学阴性的患者进行了一项使用高效价免疫球蛋白（HIg）预防的随机研究，并对这些患者进行了广泛的监测以观察活动性CMV感染和CMV疾病情况。外周血粒细胞中CMV抗原的检测（抗原血症）是原发性CMV感染的首个迹象，通常在检测到IgM或IgG抗CMV抗体以及阳性培养结果出现前数周发生。发现使用OKT3或抗胸腺细胞球蛋白（ATG）进行排斥反应治疗、CMV疾病的严重程度与移植物丢失之间存在相关性。排斥反应治疗对CMV传播的发生率没有影响。原发性CMV感染最常发生在供体年龄较大的老年患者中。从移植后第1周直到第7周给予HIg预防未见有益效果。两组原发性CMV感染的发生率相同（50%），且未见其对原发性CMV感染严重程度有影响。观察到的唯一效果是关于从移植到检测到活动性CMV感染的时间，HIg预防使其延长。
