Early cytomegalovirus reactivation after heart transplantation: A case report and literature review

Q4 Medicine

Transplantation Reports Pub Date : 2021-12-01 DOI:10.1016/j.tpr.2021.100083

Lan-Pin Kuo , Meng-Ta Tsai , Jui-Yin Kao , Yu-Ning Hu , Chi-Fu Cheng , Chun-Hao Chang , Jun-Neng Roan

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引用次数: 1

Abstract

Reactivation of cytomegalovirus is one of the most significant morbidities in solid organ transplant recipients. Reports describing the risk factors for cytomegalovirus reactivation in heart transplantation are scarce. We present a case in which viral reactivation 9 days after heart transplantation resulted in cytomegalovirus enterocolitis. Before transplantation, the patient received extracorporeal membrane oxygenation. Cytomegalovirus reactivation occurred under prophylactic medication with valganciclovir and progressed to cytomegalovirus enterocolitis, complicated by ischemia and a small bowel perforation. The patient died of repeated septic shock, severe gastrointestinal tract complications, and cytomegalovirus hepatitis. A review of 70 heart transplant recipients at our hospital from 2005 to 2020 revealed that cytomegalovirus reactivation occurred more frequently in those who received pretransplantation extracorporeal membrane oxygenation than in those who did not (36.4% vs. 6.8%, P = 0.018). This finding suggests that early diagnosis and prompt management of cytomegalovirus reactivation in patients receiving extracorporeal membrane oxygenation as a bridge to heart transplantation is crucial.

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心脏移植术后早期巨细胞病毒再激活一例报告并文献复习

巨细胞病毒再激活是实体器官移植受者最重要的发病之一。关于心脏移植中巨细胞病毒再激活的危险因素的报道很少。我们报告了一例心脏移植后9天病毒再激活导致巨细胞病毒小肠结肠炎的病例。移植前，患者接受体外膜氧合。在使用缬更昔洛韦预防性治疗后，巨细胞病毒再次激活，并发展为巨细胞病毒性小肠结肠炎，并发缺血和小肠穿孔。患者死于反复感染性休克、严重胃肠道并发症和巨细胞病毒性肝炎。对我院2005年至2020年70例心脏移植受者的回顾显示，移植前接受体外膜氧合的患者巨细胞病毒再激活的发生率高于未接受体外膜氧合的患者(36.4%比6.8%，P = 0.018)。这一发现表明，在接受体外膜氧合作为心脏移植桥梁的患者中，早期诊断和及时处理巨细胞病毒再激活是至关重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation Reports Medicine-Transplantation

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

101 days

期刊介绍： To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI