Monitoring of Cytomegalovirus, Epstein-Barr Virus, and Human Herpesvirus 6 in Pediatric Liver Transplant Recipients

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  • 小児生体肝移植後のcytomegalovirus, Epstein-Barr virus, human herpesvirus 6の実態に関する検討
  • ショウニ セイタイ カン イショクゴ ノ cytomegalovirus Epstein Barr virus human herpesvirus 6 ノ ジッタイ ニ カンスル ケントウ

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Abstract

Purpose: Pediatric liver transplant recipients are often infected with human herpesviruses. Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6) cause sometimes life-threatening infection. Our object was to monitor CMV, EBV, and HHV-6. Methods: From June 2004 to December 2007, 17 pediatric liver transplants were performed in our hospital. CMV were monitored with antigenemia (C7-HRP), EBV were monitored with real-time PCR method, and HHV-6 were monitored with the cytopathic effect of the mononuclear cells. Results: The detection rate of CMV was 8/17 (47.1%), and CMV were detected about one month after transplantation. None of the patients was infected with CMV 90 days postoperatively. The detection rate of EBV was 8/17 (47.1%), and EBV were detected at any time for 30 months after transplantation. Seven of eight patients in whom EBV were detected were in the non-infected group before transplantation. HHV-6 was detected with five patients. Four of them suffered primary HHV-6 infection with the liver graft. All of them had fever, and three of them had decreasing of platelets and liver disfunction, but none of them had the rash after fever. Conclusions: Human herpesviruses are detected at a high rate after pediatric liver transplantation. CMV, EBV, and HHV-6 were detected at 47.1%, 47.1%, 29.4%, respectively. Although many of the patients did not present the symptoms of illness, sometimes critical complications may be caused and the early detection by periodical monitoring is important.

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