儿童脏移植中的BK多瘤病毒负担:比利时的经验
Pauline Guillaume-Gentil1, Benedetta Chiodini1, Brigitte Adams2
1Department of Pediatric Nephrology, Hôpital Universitaire de Bruxelles-HUDERF (HUB-HUDERF), Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium.
Biomedicines
|February 27, 2026
概括
监测儿童移植患者的BKPyV-DNAemia至关重要. 然而,仅仅依赖病毒载量可能会导致过度治疗和并发症;为了最佳的移植保存,需要个性化的方法.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 在儿科移植中,BK多病毒 (BKPyV) 感染是一个重大问题.
- BKPyV-DNAemia和BKPyV-nephropathy可能会影响移植结果.
- 早期发现和管理对于长期成功至关重要.
研究的目的:
- 评估比利时儿科脏移植接受者中BKPyV-DNAemia和BKPyV-nephropathy的发生率和结果.
- 评估BKPyV感染对移植后两年内移植功能和排斥的影响.
- 为了确定BKPyV-DNAemia发展的潜在风险因素.
主要方法:
- 对86名儿科移植接受者进行了回顾性研究,这些接受者在2010年至2022年间接受了移植.
- 监测BKPyV-DNAemia (≥10^4副本/毫升超过2周) 和假定的BKPyV-病.
- 进行了活检以确认BKPyV-病.
- 评估急性细胞排斥和估计的膜过率 (eGFR) 在2年和最后的随访.
主要成果:
- 13%的患者在移植后两年内出现显著的BKPyV-DNAemia,主要是在头六个月内.
- 在11名患有BKPyV-DNAemia的患者中,4名患有活检证明的BKPyV-nephropathy.
- 在这些患者中,36%的患者经历了免疫抑制降低后的急性细胞排斥.
- 移植功能 (eGFR) 在活检证明的BKPyV-nephropathy患者中明显较低,而不是那些假定的BKPyV-nephropathy患者.
结论:
- 在儿科移植接受者中,监测BKPyV-DNAemia是必不可少的.
- 仅基于病毒载荷的决定可能导致过度治疗和免疫学并发症.
- 需要采用个性化方法,整合病毒,临床和免疫学标记,以平衡感染控制和移植保存.
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