Next generation sequencing screening for human parvovirus B19 infection after liver transplantation and the analysis of related risk factors
10.3969/j.issn.1674-7445.2019.06.011
- VernacularTitle:肝移植术后人类细小病毒B19感染的二代测序筛查及其相关危险因素分析
- Author:
Tuo CHEN
1
;
Ruidong LI
;
Yue YING
;
Yifeng TAO
;
Conghuan SHEN
;
Yanting JIN
;
Zhengxin WANG
Author Information
1. Department of General Surgery, Liver Transplantation Center, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
- Publication Type:Research Article
- Keywords:
Liver transplantation;
Human parvovirus B19;
Pure red cell aplasia;
Next generation sequencing;
Risk factor;
Infection;
Immune rejection;
Donation after cardiac death;
Intravenous immunoglobulins;
Human herpesvirus
- From:
Organ Transplantation
2019;10(6):696-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the screening Methods for human parvovirus (HPV) B19 infection after liver transplantation and analyze the related risk factors. Methods Clinical data of 86 recipients were retrospectively analyzed. According to the Results of next generation sequencing (NGS), all recipients were divided into the HPV B19 infection group and control group. Clinical characteristics, treatment regime and clinical prognosis of patients infected with HPV B19 were analyzed. The risk factors of HPV B19 infection were analyzed using univariate and multivariate Logistic regression model by forward LR step method. Results Nine of the 86 recipients developed fever and progressive anemia with unexplained reasons at approximately 2 weeks after liver transplantation. NGS detection demonstrated that HPV B19 was positive and they were diagnosed with pure red cell aplasia (PRCA) caused by HPV B19 infection. After intravenous immunoglobulins (IVIG) was given and the immunosuppressant therapy was adjusted, the hemoglobin levels in all patients were significantly increased. The Results of multivariate analysis revealed that low serum globulin level in peripheral blood at postoperative 7 d [odds ratio (OR) =0.749, P=0.040] and young age (OR=0.937, P=0.038) were the independent risk factors of HPV B19 infection after liver transplantation. Conclusions HPV B19 infection should be considered in relatively young patients with unexplained hemoglobin decline early after liver transplantation. NGS screening is an effective method for early diagnosis of HPV B19 infection. Low serum globulin level in peripheral blood at postoperative 7 d and young age may be independent risk factors of the incidence of HPV B19 infection.
