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Titolo:
Association of viral genome with graft loss in children after cardiac transplantation.
Autore:
Shirali, GS; Ni, JY; Chinnock, RE; Johnston, JK; Rosenthal, GL; Bowles, NE; Towbin, JA;
Indirizzi:
Baylor Coll Med, Dept Pediat Cardiol, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ediat Cardiol, Houston, TX 77030 USA Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA Baylor CollMed Houston TX USA 77030 & Human Genet, Houston, TX 77030 USA Baylor Coll Med, Dept Cardiovasc Sci, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ardiovasc Sci, Houston, TX 77030 USA Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA Med Univ S Carolina Charleston SC USA 29425 iat, Charleston, SC 29425 USA Loma Linda Univ, Childrens Hosp, Dept Ambulatory Pediat, Loma Linda, CA 92350 USA Loma Linda Univ Loma Linda CA USA 92350 Pediat, Loma Linda, CA 92350 USA Loma Linda Univ, Childrens Hosp, Dept Nursing, Loma Linda, CA 92350 USA Loma Linda Univ Loma Linda CA USA 92350 Nursing, Loma Linda, CA 92350 USA Univ Washington, Dept Pediat Cardiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ediat Cardiol, Seattle, WA 98195 USA
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 20, volume: 344, anno: 2001,
pagine: 1498 - 1503
SICI:
0028-4793(20010517)344:20<1498:AOVGWG>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
POLYMERASE-CHAIN-REACTION; IDIOPATHIC DILATED CARDIOMYOPATHY; INFANT HEART-TRANSPLANTATION; NUCLEIC-ACID HYBRIDIZATION; CORONARY-ARTERY DISEASE; COXSACKIEVIRUS B3 RNA; ENDOMYOCARDIAL BIOPSY; CYTOMEGALOVIRUS-INFECTION; ENTEROVIRUS RNA; ENDOCARDIAL FIBROELASTOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Towbin, JA Baylor Coll Med, Dept Pediat Cardiol, Rm 333E,1 Baylor Plaza, Houston, TX 77030 USA Baylor Coll Med Rm 333E,1 Baylor Plaza Houston TX USA 77030 USA
Citazione:
G.S. Shirali et al., "Association of viral genome with graft loss in children after cardiac transplantation.", N ENG J MED, 344(20), 2001, pp. 1498-1503

Abstract

Background: The survival of recipients of cardiac allografts is limited byrejection and coronary vasculopathy. The purpose of this study in childrenwho had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss. Methods: We enrolled heart-transplant recipients 1 day to 18 years old whowere undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejectionwith the use of standard criteria and were analyzed for the presence of virus by the polymerase chain reaction (PCR). Results: PCR analyses were performed on 553 consecutive biopsy samples from 149 transplant recipients. Viral genome was amplified from 48 samples (8.7 percent) from 34 patients (23 percent); adenovirus was found in 30 samples, enterovirus in 9 samples, parvovirus in 5 samples, cytomegalovirus in 2 samples, herpes simplex virus in 1 sample, and Epstein-Barr virus in 1 sample. In 29 of the 34 patients with positive results on PCR (85 percent), an adverse cardiac event occurred within three months after the positive biopsy, and 9 of the 34 patients had graft loss due to coronary vasculopathy, chronic graft failure, or acute rejection. In 39 of the 115 patients with negative results on PCR (34 percent), an adverse cardiac event occurred withinthree months of the negative PCR finding; graft loss did not occur in any of the patients in this group. The odds of graft loss were 6.5 times as great among those with positive results on PCR (P = 0.006). The detection of adenovirus was associated with considerably reduced graft survival (P = 0.002). Conclusions: Identification of viral genome, particularly adenovirus, in the myocardium of pediatric transplant recipients is predictive of adverse clinical events, including coronary vasculopathy and graft loss. (N Engl J Med 2001;344:1498-503. ) Copyright (C) 2001 Massachusetts Medical Society.

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Documento generato il 01/12/20 alle ore 08:16:08