CLINICAL AND IMMUNOLOGICAL FEATURES OF KIDNEY TRANSPLANT RECIPIENTS WITH CYTOMEGALOVIRUS INFECTION MANIFESTATION IN THE EARLY POSTOPERATIVE PERIOD
https://doi.org/10.15825/1995-1191-2013-4-24-30
Abstract
Aim. To optimize the management of postoperative renal allograft recipients through the introduction of methods for predicting risk of manifestation of cytomegalovirus infection on the basis of a comprehensive assessment of the clinical and immunological status.
Materials and methods. We retrospectively analyzed the medical records of 303 patients with end-stage renal disease, among them – were the recipients of renal allograft – 136, among whom 29 within 2 months after the operation had clinical signs of CMV infection. Assessable "CMV syndrome", laboratory evidence of CMV infection, the incidence of antigens (genes) of HLA A, B and DRB *1, calculated goodness of fit χ2 and relative risk RR, changes MCP-1 in urine.
Results. In renal allograft recipients with clinical and laboratory evidence of CMV infection in the early postoperative period, significantly more (χ2 > 3,8) met antigen B35. A positive association with CMV infection was detected also for DRB1 * 08, B21, B22, B41, A24 (9), B51 (5), DRB1*14 and DRB1*15. Protective effects possessed antigens / alleles of genes A26 (10), B14, B38 (16) B61 (40) and DRB1*16. MCP-1 levels in this group of recipients were raised to 2174,7 ± 296,3 pg/ml with a strong negative correlation with the levels of urea and creatinine in serum (r = 0,9, p < 0.001).
Conclusion. Immunological markers of risk manifestation of CMV infection in recipients of kidneys in the early postoperative period are: the carriage of В35 и В55,56(22), В49(21), В41, DRB1*08 и DRB1*15, an increase of levels of MCP-1 in urine without increasing the levels of urea and creatinine in the serum.
About the Authors
L. V. Limareva
Institute of experimental medecine and biotechnology (direktor – prof. L.T. Volova) Samara state medical University (rector – academician of RAMSci, prof. G.P. Kotelnikov), Samara, Russian Federation
A. V. Kolsanov
Chair of operative surgery and clinical anatomy with a course of innovatine technologies (Head – prof. A.V. Kolsanov) of the same University
A. A. Avdeeva
Department organ transplantation (Head – prof. I.I. Losev) at the same University, Russian Federation
O. P. Danilchenko
Institute of experimental medecine and biotechnology (direktor – prof. L.T. Volova) Samara state medical University (rector – academician of RAMSci, prof. G.P. Kotelnikov), Samara, Russian Federation
W. V. Bogush
Institute of experimental medecine and biotechnology (direktor – prof. L.T. Volova) Samara state medical University (rector – academician of RAMSci, prof. G.P. Kotelnikov), Samara, Russian Federation
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Review
For citations:
Limareva L.V., Kolsanov A.V., Avdeeva A.A., Danilchenko O.P., Bogush W.V. CLINICAL AND IMMUNOLOGICAL FEATURES OF KIDNEY TRANSPLANT RECIPIENTS WITH CYTOMEGALOVIRUS INFECTION MANIFESTATION IN THE EARLY POSTOPERATIVE PERIOD. Russian Journal of Transplantology and Artificial Organs. 2013;15(4):24-30. (In Russ.) https://doi.org/10.15825/1995-1191-2013-4-24-30
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