final program.qxd - Parallels Plesk Panel

PP 3.27
HIV-positive cases as part of viral complications after renal allotransplantation
KT Metodiev¹, PG Lazarova², VI Driyanskaya³
1
Dept.Immunology, Medical University, Varna-Bulgaria; 2 Clin.laboratory, District hospital
"St.Anna", Varna-Bulgaria; 3-Lab.immunology, Inst.Urology&Nephrology, Kiev-Ukraine
Background
It is well-known that recipients of renal allografts suffer from two major complications after
transplantation: rejection crisis and infections. The rejection process is a well-expressed
immune conflict. The infectious processes have various etiology but most often are the
viral ones, followed by bacterial and fungial.
Objectives
It is very essential that a proper, rapid and precise diagnosis, as well as a realistic
prediction of the two postoperative complications, must be performed because they
require rather different therapeutical behaviour.
Materials and methods
The authors of the present study examine dynamically 128 recipients of renal allografts
(before and after transplantation, twice weekly during the first month postoperatively, twice
monthly for the period of the first year) by using both, the immunologic monitoring (IM) and
virologic methods (VM), trying to analyse the possibilities for diagnosis and prognosis of
rejection and infections, also to investigate the etiology of viral processes. The IM includes
basic immune tests for cellular, humoral, specific and nonspecific immunity, type of
immunoreactivity and current immunomodulation, whereas the VM are directed to
antibody and antigen identifiction, also HIV-serologically positive recipients and
HIV-virocarriers (patients on haemodialysis before renal allotransplantation and patients
after operation) by using ELISA.
Results and conclusions
Based on the results the authors suggest that the applied model of IM allow statistically
reliable exact differentiation and prediction (!) of both complications (rejection and
infections). As for the viral infections (altogether 58 for the whole group of 128 recipients),
the following etiology is registered: hepatitis (21 cases or 36.2%), CMV (11 or 18.9%),
Influenza (9 or 15.5%), Adenoviral (4 or 6.9%), ECHO (2 or 3.45%), HIV-serologically
positive cases (3 or 5.2%), from them HIV-virocarriers (2 or 3.45), mixed viral infections
(6 or 10.4%). The immunoreactivity type of the recipients shows that the lower the
immune status is, the oftener are the infections, especially those with viral origin.
Expressed immunodeficiency is registered in 7 cases (CMV-2, Influenza-1, mixed viral
infection-1 and HIV-3). Detailed analysis of the therapy (antiinfective and
immunosuppressive) for both posttransplantation complications is proposed. The model of
IM allows a very reliable analysis and prediction of the immune conflict or infections in the
postoperative periods, thus giving a precise idea for the exact therapy of allograft patients.
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