The Clinical Significance of Cytomegalovirus Infection in Renal Transplant Recipients

Rifkind, David; Goodman, Neal; Hill, Rolla B.

doi:10.7326/0003-4819-66-6-1116

Cited by 129 publications

(24 citation statements)

References 36 publications

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“…Since then, clini cally apparent CMV in the adult population has been found with increasing frequency [2,11]. The disease is common following immunosuppressive the rapy after organ transplants [3,18], with treatment for acute leukemia or malignant lymphoma [1,5] and after transfusion of blood which had been stored for less than 48 h [9,14]. In patients with malignant disease, CMV of ten is the last of a series of complications and frequently is not recognized before death.…”

Section: Introductionmentioning

confidence: 99%

Rapidly Fatal Cytomegalovirus Pneumonia in Hodgkin’s Disease

Mikus¹,

Carrington²,

Gaensler³

1974

Respiration

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Section: Introductionmentioning

confidence: 99%

Rapidly Fatal Cytomegalovirus Pneumonia in Hodgkin’s Disease

Mikus¹,

Carrington²,

Gaensler³

1974

Respiration

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“…Cytomegalovirus (CMV) rarely causes clinically ap parent disease in normal adults but is an important pathogen in compromised hosts [1,2]. CMV may cause interstitial pneumonitis, the mononucleosis syndrome, hepatitis, ulcerations in the gastrointestinal tract, throm bocytopenia, hemolytic anemia, retinitis, and menin goencephalitis [1,3.…”

Section: Introductionmentioning

confidence: 99%

Acquired Cytomegalo virus Retinitis

Moeller¹,

Gutman²,

Hamilton³

1982

Am J Nephrol

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49 cases of acquired cytomegalovirus retinitis were reviewed including three new cases in renal allograft recipients and one in a patient with Hodgkin’s Disease. Diagnosis in over 90% of cases was based on the distinctive funduscopic appearance of cytomegalovirus (CMV) retinitis. When performed, urine, subretinal fluid, and blood buffy coat cultures were positive for CMV in 97, 67 and 39% of cases, respectively. More than two-thirds of these patients were organ transplant recipients who received chronic immunosuppressive therapy. Attempted therapy of CMV retinitis with a variety of regimens has not been proven to be effective. At present, no specific treatment is recommended unless it is given under a controlled therapeutic trial.

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“…Shortly thereafter, renal transplant recipients were shown to have a high incidence of viral infections, mainly as a result of cytomegalovirus (CMV) and other herpes viruses. Virologic and serologic studies demonstrated that these could be either primary or reactivated latent infections with a wide spectrum of clinical severity (2,3).…”

mentioning

confidence: 99%

Histologic versus Molecular Diagnosis of BK Polyomavirus–Associated Nephropathy

Drachenberg

Papadimitriou²,

Ramos³

2006

Clinical Journal of the American Society of Nephrology

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Although discovered in 1970 the BK virus infections had no significant clinical impact until the emergence of BK virusassociated allograft nephropathy (BKPVAN). Escalating clinical challenges required better diagnostic tools and delineation of uniform criteria for diagnosis. In recent years, the widespread use of real-time PCR for measuring viral loads has confirmed that BK viruria and viremia are consistently identified before the development of overt nephritis. The identification of this viruria-viremia-nephritis sequence has provided tools for screening renal transplant patients and the possibility of earlier intervention with improved outcomes. Analysis of current clinical trends indicates that despite the fact that a positive renal biopsy is the "gold standard" for the diagnosis of BKPVAN, clinical interventions often are based on the surrogate markers of the disease rather than on tissue diagnosis. This is conceptually supported by the fact that early BKPVAN is focal and liable to tissue sampling errors. Strong arguments remain, however, in favor of retaining the requirement for tissue evaluation in patients who are suspected of having BKPVAN. BKPVAN selectively affects the graft and is likely to occur in a background of immune and/or nonimmune renal injury. A renal biopsy is necessary to exclude other pathologic processes (e.g., acute rejection) that could coexist with BKPVAN or be the main cause of allograft dysfunction. Evaluation of a renal biopsy for the purpose of staging is important for prognosis and is also of paramount importance for the rational assessment of therapeutic success.

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The Clinical Significance of Cytomegalovirus Infection in Renal Transplant Recipients

Cited by 129 publications

References 36 publications

Rapidly Fatal Cytomegalovirus Pneumonia in Hodgkin’s Disease

Rapidly Fatal Cytomegalovirus Pneumonia in Hodgkin’s Disease

Acquired Cytomegalo virus Retinitis

Histologic versus Molecular Diagnosis of BK Polyomavirus–Associated Nephropathy

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