Cytomegalovirus Disease in Renal Allograft Recipients: Experience of a Single Center

賢移植術接受者的巨細胞病毒疾病：單一醫學中心之臨床經驗

洪東衛(Tung-Wei Hung) ； 張浤榮(Horng-Rong Chang) ； 吳勝文(Sheng-Wen Wu) ； 林智廣(Chih-Kuang Lin) ； 連榮達(Jong-Da Lian)

《Acta Nephrologica》 23卷1期 (2009/03) Pp. 21-25

並列摘要

Background: This analysis is to investigate the clinical presentations of cytomegalovirus (CMV) disease in kidney transplant recipients.
Methods: We conducted the CMV polymerase chain reaction (PCR) survey among kidney transplant recipients if the patient presented with suspected symptoms, including fever, hematologic abnormalities, gastrointestinal symptoms, abnormal live, function, and allograft dysfunction from January 2002 to December 2004, Direct CMV detection was performed in urine and blood samples by a qualitative PCR method CMV disease was defined as CMV-associated symptoms with positive CMV PCR. The clinical presentations and outcomes were reviewed.
Results: Of the 164 kidney transplant recipients, we detected 10 patients (6.1%) with CMV disease. The CMV disease was diagnosed at 2.4±1.3 months post transplantation. The clinical symptoms and signs included fever in 10 patients, elevated serum creatinine in 6, raised liver enzyme in 5, abdominal pain in 4, vomiting in 2, diarrhea in 2, thrombocytopenia in 4, leucopenia in 4, and ischemic colitis with mortality in 1. All the patients received intravenous gancyclovir with clinical response except one died from ischemic colitis.
Conclusion: The possibility of CMV disease should be explored if a kidney transplant patient presented with fever and/or CMV associated symptoms within 6 months post transplantation. It is beneficial if CMV disease can be diagnosed earls so that adequate antiviral therapy can be offered.