固体器官移植中的HHV-8/KSHV:当前知识差距和未来方向
Alessandra Mularoni1,2, Andrea Cona1,2, Malgorzata Mikulska3,4
1IRCCS ISMETT, Palermo, Italy.
概括
在固体器官移植 (SOT) 接受者中,HHV-8/KSHV相关疾病 (KADs) 正在增加. 早期检测和管理,包括卡波西.
科学领域:
- 移植医学 移植医学 移植医学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- 固体器官移植 (SOT) 接受者面临着增加HHV-8/KSHV相关疾病 (KADs) 的风险.
- 评估HHV-8/KSHV影响的挑战包括区域血清流行率变化和不一致的查.
- 像卡波西肉瘤 (KS) 和淋巴瘤这样的新发性KAD以及非恶性卡波西肉瘤相关的疹病毒炎症细胞因子综合征 (KICS) 是SOT的担忧.
研究的目的:
- 为SOT接收者提供KAD的最新概述,重点关注KICS.
- 突出目前的知识差距和查和管理的最新进展.
- 强调需要改进的诊断工具和前性研究.
主要方法:
- 对SOT中HHV-8/KSHV相关疾病的当前文献的综述.
- 专注于KICS的临床表现,诊断和管理策略.
- 讨论潜在的临床方案和研究需求.
主要成果:
- 严重炎症和潜在多器官衰竭的非恶性综合征KICS是一个重大问题.
- 捐赠者衍生的KICS和KS可以在没有典型的皮肤参与的情况下出现,需要提高意识.
- 目前的管理策略包括捐赠者/接受者测试,监测DNAemia,免疫抑制修饰,抗病毒药物和rituximab.
结论:
- 缺乏针对HHV-8/KSHV的标准化血清检测.
- 需要前性研究来验证监测,预防性管理和治疗方案.
- 改善诊断和临床意识对于及时诊断和治疗SOT患者的KAD至关重要.
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