Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-28T11:59:57Z No. of bitstreams: 1 469455 - Texto Completo.pdf: 4993843 bytes, checksum: 7aeda1318711d77b5835d47f0530f35c (MD5) / Made available in DSpace on 2015-05-28T11:59:57Z (GMT). No. of bitstreams: 1 469455 - Texto Completo.pdf: 4993843 bytes, checksum: 7aeda1318711d77b5835d47f0530f35c (MD5) Previous issue date: 2007-03-30 / The present study evaluates aspects of polyomavirus infection in renal transplant patients. Recently, BK virus has been recognized as an important infectious agent because BK virus associated nephropathy (BKVN) has emerged as a significant cause of allograft failure. Currently, studies on its prevalence, risk factors, diagnostics and therapeutics methods, in different populations, are underway around the world. To date, this ?newly emerged? infection remains mysterious in many aspects. The methods used to diagnosis polyomavirus infection are urinary cytology, urinary and plasmatic viral PCR and renal histology. Urinary cytology is an inexpensive and a simple method where urothelial cells with intranuclear viral inclusions are sought; these are called decoy cells and are thought to represent viral replication. The prevalence of decoy cells in renal transplants recipients is between 20 and 60%. Of these, 1 to 8% develops BKV nephropathy in witch case up to 80% may lose their grafts. No data on the prevalence of decoy cells in pancreas graft recipients has been published so far. In this study, we evaluated the prevalence of decoy cells in kidney, pancreas and kidney-pancreas recipients. The presence of decoy cells has been correlated with clinical variables, in an attempt to analyze risk factors. Two hundred and twenty one patients, 18 years-old or older, with more than 1 month follow up after transplantation, that attended the outpatients clinic between September and December 2006 were studied. The total prevalence of decoy cells was 16% (16.9% in kidney recipients, 5.9% in simultaneous kidney-pancreas recipients and 20% in pancreas alone recipients). There were no statistically significant differences between patients with either positive or negative urinary cytology for decoy cells, regarding demographic (gender, age, race) or clinical (time post-transplantation, donor type and history of delayed graft function or rejection, other associated viral infections and type of immunosuppressive drugs employed) variables. / O presente trabalho aborda aspectos relacionados ? infec??o por poliomav?rus em pacientes transplantados de rim e p?ncreas. Este v?rus teve sua import?ncia destacada nos ?ltimos anos, em virtude da descoberta de sua associa??o com uma nefropatia respons?vel por redu??o significativa da sobrevida do enxerto renal. Muitos estudos est?o em andamento para avaliar a ocorr?ncia do v?rus em diferentes popula??es, seus fatores de riscos, m?todos para diagn?stico e terap?uticas. At? o momento, esta ?nova? infec??o permanece misteriosa em muitos aspectos. Os m?todos para diagn?stico da infec??o pelo poliomav?rus consistem de citologia urin?ria, pesquisa do v?rus por PCR na urina e sangue e histologia renal. A citologia urin?ria ? um m?todo de f?cil realiza??o e baixo custo, onde pesquisa-se a ocorr?ncia de c?lulas epiteliais com inclus?es virais intranucleares, denominadas de c?lulas decoy. Estas c?lulas sugerem replica??o viral. A preval?ncia de c?lulas decoy em pacientes transplantados renais varia de 20 a 60%. Destes, cerca de 1 a 8% desenvolvem nefropatia relacionada ao v?rus, associada com perda de enxerto renal variando de 10 a 80% dos casos. N?o h? relatos sobre preval?ncia de c?lulas decoy em transplantados pancre?ticos. Neste trabalho, avaliou-se a preval?ncia das c?lulas decoy em pacientes transplantados de rim, p?ncreas e p?ncreas-rim no nosso meio. A ocorr?ncia de positividade das c?lulas decoy foi correlacionada com diferentes vari?veis cl?nicas, para avaliar fatores de risco associados. Foram avaliados 231 pacientes, maiores de 18 anos, com mais de 1 m?s de transplante, que consultaram no ambulat?rio no per?odo de setembro a dezembro de 2006. A preval?ncia total de c?lulas decoy em pacientes transplantados no Hospital S?o Lucas da PUCRS foi de 16% (16,9% em pacientes transplantados de rim, 5,9% em pacientes com transplante simult?neo de p?ncreas e rim e 20% em pacientes transplantados de p?ncreas isolado). N?o houve diferen?a estatisticamente significativa entre os pacientes com citologia positiva e negativa para c?lulas decoy em rela??o as vari?veis demogr?ficas (sexo, idade e ra?a) ou cl?nicas (tempo em transplante, tipo de transplante, tipo de doador, hist?ria de disfun??o prim?ria ou rejei??o, outras infec??es virais associadas e tipo de imunossupress?o).