Infección y enfermedad por citomegalovirus en niños sometidos a trasplante de órgano sólido: Experiencia en un centro de referencia chileno

Abstract

Cytomegalovirus infection and disease in pediatric solid organ transplantation. Experience in a Chilean multiorganic transplantation center Cytomegalovirus (CMV) infection and disease in transplant (Tx) recipients may severely complicate the patients outcome. Aim: To determine the incidence, clinical characteristics and risk factors for CMV infection and disease in liver and kidney transplant recipients in a tertiary care children's hospital. Method: A clinical and laboratory evaluation was prospectively performed in 44 and 20 children receiving a renal and liver Tx respectively in the Hospital Luis Calvo Mackenna between 2004 and 2006. Results: At the time of the organ Tx 20.3% (13/64) children were seronegative for CMV. Thirty six per cent (23/64) patients were infected with CMV, of whom 32% (14/44) received kidney Tx and 9/20 (45%) received liver Tx. CMV disease occurred in 52% (12/23) of infected patients. CMV disease was characterized by fever (100%), anemia (50%), leucopenia (16.6%) and specific organ involvement (renal graft 60% liver graft 57.1%, lung 25%, intestine 16.6%). Variables significantly associated with infection were a CMV seronegative status (p = 0.035) and lower age 5.5 + 3.7 years old vs 8.3 + 4.4 years old (p = 0.01). Conclusions: Incidence of CMV infection was high in children receiving a solid organ transplant in our institution and near half of infected children developed CMV-associated disease.

Efectos de la infección y la enfermedad por citomegalovirus en receptores de trasplante renal

“…en un análisis de 207 trasplantados renales españoles 15.7% presentaron infección por el virus y de éstos 17.2% desarrollaron la enfermedad (52). en Latinoamérica se han publicado muy pocos estudios sobre el tema y la mayoría son pequeñas series de pacientes (25,37,39,40,51,53,54,64). Un pequeño estudio colombiano (30) en el que se midieron anticuerpos contra los agentes del síndrome TORCHS a 60 gestantes en Medellín se encontró una seroprevalencia del 66% para CMv y en otro estudio (31) en 455 muestras en la misma ciudad se encontró un porcentaje de infección de 89% en receptores de trasplante renal, 81% en donantes intrafamiliares, 73% en donantes cadavéricos y 74% en individuos normales.…”