肾移植受者BK病毒感染情况分析

Analysis of BK virus infection in kidney transplant recipients

目的比较同时期亲属活体供肾移植(LD)受者与尸体供肾移植(DD)受者BK病毒的感染情况。方法纳入2015年1月至2019年8月期间解放军总医院第八医学中心器官移植研究所实施的实体器官肾移植受者911例,采用实时荧光定量PCR对肾移植受者尿液和外周血中的BK病毒DNA水平进行监测,根据供体来源不同分为LD组255例和DD组656例;比较LD组与DD组的BK病毒感染情况,探讨不同来源的供体对肾移植受者BK病毒感染的影响。结果所有研究对象BK病毒感染尿液检出率为13.06%(119/911),血液检出率为2.96%(27/911);肾移植术后BK病毒尿液检出率高于血液检出率(P<0.0001);LD组中BK病毒感染尿液检出率为9.02%(23/255),明显低于同期DD组的14.63%(96/656),差异有统计学意义(χ^2=5.097,P=0.012);LD组BK病毒感染血液检出率为0.78%(2/255),明显低于DD组的3.81%(25/656),差异有统计学意义(χ^2=5.849,P=0.007)。结论不同来源的实体器官肾移植受者BK病毒感染率差异较大,DD来源的肾移植受者BK病毒感染的发生率较高。

Objective To compare the infection of BK virus in the recipients of living donor(LD)kidney transplant and deceased donor(DD)kidney transplant.Methods A total of 911 recipients who underwent kidney transplantation in the Organ Transplantation Research Institute of the 8th Medical Center of the People′s Liberation Army General Hospital from January 2015 to August 2019 were enrolled in this study.The DNA copies of BK virus in urine and peripheral blood of kidney transplant recipients were detected by real-time quantitative PCR.The patients were divided into LD group(n=255)and DD group(n=656).BK virus infection in recipients with DD kidney transplant were compared with that in recipients of LD kidney transplant.Results The BK virus positive rate in the urine of all subjects was 13.06%(119/911),and that in blood was 2.96%(27/911).The positive rate of BK virus in urine after kidney transplantation was significantly higher than that in blood(P<0.0001).The positive rate in urine was 9.02%(23/255)in LD group,which was significantly lower than that of 14.63%(96/656)in DD group in the same period(χ^2=5.097,P=0.012);The positive rate of BK virus infection in relatives group was 0.78%(2/255),which was significantly lower than that of 3.81%(25/656)in DD group(χ^2=5.849,P=0.007).Conclusions There was a significant difference in the infection rate of BK virus between the LD and DD group.The incidence of BK virus infection in kidney transplant recipients from DD was higher than that of from LD kidney transplant recipients.