Predictive factors for cytomegalovirus reactivation in cytomegalovirus‐seropositive kidney‐transplant patients

Abstract

The aims of the present study were to assess the incidence of cytomegalovirus (CMV) reactivation, and to determine the predictive factors for CMV reactivation in CMV seropositive kidney-transplant patients. One hundred ninety CMV seropositive kidney-transplant patients were included in this study; of these, 39 patients had received CMV prophylaxis. CMV DNAemia was assessed by real-timepolymerase chain reaction assay every 2 weeks until day 120, then every 3-4 weeks until day 180, and then every month until day 365. One hundred seven patients (56.3%) had at least one positive CMV DNAemia within the first year. The time between renal transplantation and the first positive CMV DNAemia was 59 +/- 5 days. The number of positive CMV DNAemia/patient was 3.28 +/- 0.22. CMV viral load at first positive CMV DNAemia was 704 (10-742,000) copies/ml. The donor CMV seropositivity, the absence of CMV prophylaxis, and the occurrence of acute rejection before CMV reactivation were independent factors associated with CMV reactivation within the first year after kidney transplantation. Hence, CMV reactivation is frequent after kidney transplantation. CMV prophylaxis in CMV seropositive kidney-transplant patients should be offered to avoid CMV-related side-effects.

Pre-emptive intravenous ganciclovir versus valganciclovir prophylaxis for de novo cytomegalovirus-seropositive kidney-transplant recipients

“…This is in accordance with previous publications that demonstrated a higher risk of CMV infection or CMV disease with a maintenance immunosuppression containing ciclosporine A [18,19]. Additionally, we have found that donor HCMV-seropositivity is an independent risk factor for HCMV reactivation after kidney transplantation in HCMV-seropositive patients [22].…”

502: CMVIG Decreases the Risk of Cytomegalovirus Infection but Not Disease after Pediatric Lung Transplantation

“…In pediatric lung transplant, the impact of adding CMVIG to standard antiviral prophylaxis has not been previously explored. The risks for CMV infection and disease in this cohort are similar to those reported previously in both the adult and pediatric literature, with increased risk during the early transplant era and with donor/recipient CMV seropositivity [5,[20][21][22][23].…”

Cytomegalovirus Immunoglobulin Decreases the Risk of Cytomegalovirus Infection but not Disease After Pediatric Lung Transplantation

“…In pediatric lung transplant, the impact of adding CMVIG to standard antiviral prophylaxis has not been previously explored. The risks for CMV infection and disease in this cohort are similar to those reported previously in both the adult and pediatric literature, with increased risk during the early transplant era and with donor/recipient CMV seropositivity [5, 20–23]. …”