肾移植术后巨细胞病毒感染与急性排斥反应

目的 :探讨肾移植术后活动性巨细胞病毒 (CMV)感染的发生率、原因以及对急性排斥反应的影响。方法 :检测 182例肾移植受者及其供者术前血清抗CMV抗体 ,受者术后定期PCR法检测体内CMVDNA ,对CMVDNA阳性的部分患者给予抗CMV治疗 ,并比较各组排斥反应的发生率。结果 :无论是供者还是受者 ,术前如血清抗CMV抗体阳性 ,受者术后发生活动性CMV感染者明显增多 ,且急性排斥反应的发生率亦明显增加 ;接受抗病毒治疗急性排斥反应明显减少。结论 :CMV感染是肾移植术后急性排斥反应的原因之一 ,预防和治疗CMV感染对肾移植术后急性排斥反应的防治具有重要意义。

Cytomegalovirus infection and acute rejection afte r kidney transplant

Aim:To investigate the incidence and cause of cytomegalovirus (CMV) infection and the relationship between acute rejection and CMV infection after kidney transplant.Methods: A total of 182 consecutive renal transplant recipients and their donors were subjected to the serum test for CMV antibody before transplantation. CMV DNA was detected by PCR after operation.Part of patients with positive CMV DNA were treated with anti CMV.Results:If the CMV antibody of either the donor or the recipient was positive, the CMV infection rate increased significantly and the development of acute rejection at least during the first 3 months following transplantation were enhanced.Ganciclovir therapy significantly reduced the incidence of acute rejection.Conclusion: It is indicated that CMV infection increased the incidence of kidney allograft rejection.It is important to prevent and treat CMV infection after kidney transplant.