Experimental Study Of Renal Transplant Recipients Infected With Human Cytomegalovirus

Objective To try to find out the changes of experimental markers of renal transplant recipients infected with human cytomegalovirus (CMV) and discuss the correlation of these markers for diagnosing CMV infection and preventing occurrence of CMV disease.Methods Series of techniques, including Real-Time PCR, CMV pp65 antigen assay and flow cytometry analysis were used to detect the samples of the transplant recipients.Results (1) In 14 weeks after renal transplantation, the positive rate of CMV DNA in urine, plasma and leukocytes were 70.4%> 77.8% and 85.2%, respectively. In 24 weeks after renal transplantation, the positive rate of CMV DNA in urine, plasma and leukocytes were 86.7% ^ 93.3% and 100%, respectively. (2) In 14 weeks after renal transplantation, the loads of CMV DNA in urine, plasma and leukocytes increased as the time following renal transplantation prolonged. (3) The peak values of positive rate of CMV DNA in urine, plasma and leukocytes appeared at the 12th week, the 8th week and 10th week after renal transplantation, respectively. (4) In the 8th week after renal transplantation, the correlations between the loads of CMV DNA in urine and CD3+ T lymphocytes (P=0.0055), CD4+ T lymphocytes (P=0.0065), CD56+ T lymphocytes (P=0.0276) and creatinine (P=0.0273) are significant, respectively. But in this week, the correlations between the loads of CMVDNA in urine and CD8+ T lymphocytes, glutamic-oxalacetic transaminase and blood uria nitrogen are not significant (P>0.05); The correlations only between alanine aminotransferase and the loads of CMV DNA in plasma and leukocytes are significant (P<0.0001), respectively. (5) It demonstrated that many leukocytes surrounded and adhered to a protein-like material, in which there were several pp65-positive cytomegalic endothelial cells detected. The component and the function of this protein-like material and the character of these leukocytes are unknown yet.Conclusion (1) It is concluded that CMV infection is common in patients receiving renal transplants. (2) The Real-Time PCR assay for the quantification of CMV DNA may provide a useful tool that can be used to monitor disease progression. (3) It is essential to bethink of CMV infection when CD3+ T lymphocytes, CD4+ T lymphocytes, CD56+ T lymphocytes, creatinine or alanine aminotransferase of renal transplant recipients are abnormal. (4) The detailed relation between CMV infection and protein-like material formation needs further investigation.