KARACİĞER NAKLİ ALICILARINDA LATENT Epstein-Barr VİRÜS VE SİTOMEGALOVİRÜS ENFEKSİYON PROFLAKSİSİ

Yıl 2019, Cilt: 14 Sayı: 2, 104 - 107, 16.04.2019

Gokhan Ertugrul Mustafa Salih Akin

Öz

İmmünsüpresif
ilaçlar karaciğer nakli alıcısını latent Epstein Barr virüs (EBV) ve
sitomegalovirüs (CMV) enfeksiyonlarının
reaktivasyonuna yatkınlaştırır. Bu hastalara verilen profilaktik tedaviler,
reaktivasyonun önlenmesi için çok önemlidir. Bu çalışmanın amacı, karaciğer
nakli alıcılarında latent EBV ve CMV enfeksiyonlarının profilaksisini
değerlendirmektir. Bu çalışma retrospektiftir. Çalışmada karaciğer nakli
alıcılarının Nisan 2014–Nisan 2017 tarihleri arasında EBV DNA, CMV DNA ve
profilaktik tedavi sonuçları ile incelendi. 170 alıcı hastaya proflaktik tedavi
için Valgansiklovir verilmişti.
48 aylık takipte EBV ve CMV’nin herhangi bir reaktivasyonu tespit edilmedi. Valgansiklovir, karaciğer nakli alıcılarında latent EBV ve
CMV enfeksiyonunun profilaktik tedavisinde başarılı görünmektedir.

Anahtar Kelimeler

Karaciğer Nakli, Latent EBV Enfeksiyonu, CMV Enfeksiyonu, Proflaksi, İmmünsüpresif ilaçlar

Kaynakça

• 1. Stratta, R.J., Pietrangeli, C., And Baillie, G.M., (2010). Defining The Risks for Cytomegalovirus Infection and Disease After Solid Organ Transplantation. Pharmacotherapy, 30:144-157.
• 2. Beam, E. and Razonable, R.R., (2012). Cytomegalovirus in Solid Organ Transplantation: Epidemiology, Prevention, and Treatment. Curr Infect Dis Rep, 14:633–641.
• 3. Razonable, R.R. and Paya, C.V., (2003). Herpesvirus Infections in Transplant Recipients: Current Challenges in The Clinical Management of Cytomegalovirus and Epstein-Barr Virus İnfections. Herpes, 10:60–65.
• 4. Cannon, M.J., Schmid, D.S., and Hyde, T.B., (2010). Review of Cytomegalovirus Seroprevalence and Demographic Characteristics Associated with İnfection. Rev Med Virol, 20:202–213.
• 5. Atabani, S.F., Smith, C., Atkinson, C., Aldridge, R.W., Rodriguez-Perálvarez, M., Rolando, N., et al., (2012). Cytomegalovirus Replication Kinetics in Solid Organ Transplant Recipients Managed By Preemptive Therapy. Am J Transplant, 12:2457-2464.
• 6. Razonable, R.R. and Humar, A., (2013). Cytomegalovirus in Solid Organ Transplantation. Am J Transplant, 13:93-106.
• 7. Manuel, O., Kralidis, G., Mueller, N.J., Hirsch, H.H., Garzoni, C., Van Delden, C., et al., (2013). Impact of Antiviral Preventive Strategies on the Incidence and Outcomes of Cytomegalovirus Disease in Solid Organ Transplant Recipients. Am J Transplant, 13:2402-2410.
• 8. Winston, D.J., Emmanouilides, C., and Busuttil, R.W., (1995). Infections in Liver Transplant Recipients. Clin Infect Dis, 21:1077–1091.
• 9. Stratta, R.J., Shaefer, M.S., Markin, R.S., Wood, R.P., Kennedy, E.M., Langnas, A.N., et al., (1989). Clinical Patterns of Cytomegalovirus Disease After Liver Transplantation. Arch Surg, 124:1443–1450.
• 10. Paya, C.V., Hermans, P.E., Wiesner, R.H., Ludwig, J., Smith, T.F., Rakela, J., et al., (1989). Cytomegalovirus Hepatitis in liver Transplantation: Prospective Analysis of 93 Consecutive Orthotopic Liver Transplantations. J Infect Dis, 160:752–758.
• 11. Morscio, J., Dierickx, D., and Tousseyn, T., (2013). Molecular pathogenesis of B-cell Posttransplant Lymphoproliferative Disorder: What do We Know so far?, Clin. Dev. Immunol, 1508359.
• 12. Yoon, S.O., Yu, E., Cho, Y.M., Suh, C., Kim, K.M., Han, D.J., et al., (2012). Post-transplant Lymphoproliferative Disorders: Clinicopathological Analysis of 43 Cases in a Single Center, 1990–2009, Clin. Transplant, 26:67–73.
• 13. Caillard, S., Porcher, R., Provot, F., Dantal, J., Choquet, S., Durrbach, A., et al., (2013). Post-transplantation lymphoproliferative Disorder After Kidney Transplantation: Report of a Nationwide French Registry and the Development of a New Prognostic Score, J. Clin. Oncol, 31:1302–1309.
• 14. Razonable, R.R. and Humar, A., (2013). The AST Infectious Diseases Community of Practice. Cytomegalovirus in Solid Organ Transplantation. Am J Transpl, 13:93–106.
• 15. Hopwood, P.A., Brooks, L., Parratt, R., Hunt, B.J., Bokhari, M., Thomas, J.A., et al., (2002). Persistent Epstein–Barr Virus İnfection: Unrestricted Latent and Lytic Viral Gene Expression in Healthy İmmunosuppressed Transplant Recipients, Transplantation, 74:194–202.
• 16. Engels, E.A., Pfeiffer, R.M., Fraumeni, J.F. Kasiske, B.L., Israni, A.K., Snyder, J.J., et al., (2011). Spectrum of Cancer Risk among US Solid Organ Transplant Recipients, JAMA, 306:1891–1901.
• 17. Kotton, C.N., Kumar, D., Caliendo, A.M., Asberg, A., Chou, S., Danziger-Isakov, L., et al.. (2013). Updated International Consensus Guidelines on The Management of Cytomegalovirus in Solid-Organ Transplantation. Transplantatio, 96:333-360.