Bazán-Borges A, Espinoza-Hernández R, Delgado-Ochoa MD, Vargas-Bravo C

Language: Spanish
References: 16
Page: 9-15
PDF size: 287.64 Kb.

ABSTRACT

Introduction. Cytomegalovirus (CMV) is a β-human herpesvirus HHV5, intracellular cytoplasmic inclusions produces and presents a long life cycle, is the largest of the herpesviruses and has a genome of 230 million daltons of DNA molecules encoding 230 proteins, has approximately 200 open reading frames. It is the largest known virus that infects humans. Objective. To study the frequency of cytomegalovirus infection in renal transplant patients in the Hospital Juarez de Mexico, from April 2009 to June 2010. Material and methods. Study: observational, descriptive, comparative and retrolective. Renal transplant patients were evaluated with post-transplant monitoring and review of clinical records, concentrates renal transplant protocol completed or were on the waiting list, the Juarez Hospital of Mexico between April 2009 to June 2010 with follow-up of at least 6 months for outpatients. Results. 24 patients were transplanted DVR 10 (45%), DVNR 2 (5%) and DC 12 (50%). With age of 26.7 years (14-52 years), 15 (68%) males and 9 (40%) women. Four of 24 patients (16.6%) developed CMV disease (ECMV) during follow up. Three had CMV serology IgM values up to 20 times its basal level, pp65 antigenemia positive cells infected with 242 (11-932). Were treated with ganciclovir I.V. for 2 weeks, plus oral valganciclovir for 3 months. Two patients had CMV syndrome, 1 DC was handled with oral valganciclovir for 3 months. Another patient pp65 DVR with untreated high, test negative in 8 weeks. To RDVR 15 years with steroid-RA, was treated with Thymoglobulin is indicated early therapy with ganciclovir IV for 2 weeks. The ECMV, at 120 days post transplant (60-150 days). The symptoms lasted for 2 months (8-16 weeks). The 3 transplant recipients developed symptomatic DC ECMV associated with pancreatitis, bleeding esophageal ulcers, graft infection resistant (E. coli and P. aureaginosa), intestinal obstruction secondary to parasites (Strongyloides stercoralis and Hymenolepis nana). In a nephrectomy was performed, and another required ileostomy resolve intestinal obstruction. Conclusions. CMV disease is common in cadaveric donor transplant are risk factors induction, immunosuppression, age and expanded criteria donor. There is a high morbidity in our patients (21%). The pp65 antigenemia is an effective method to monitor transplant patients.

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