The Effect of Cytomegalovirus Infection on Renal Allograft Function and Rejection in a Rat Model

Jh, Bruning; Bruggeman, C. A.; Pj, van Breda Vriesman

doi:10.1097/00007890-198904000-00040

Cited by 6 publications

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“…Previous studies have suggested that post-transplant CMV infection has an adverse effect on patient and allograft survival [19,30,31] and is a significant provocateur of acute rejection [32,33]. However, in our series of pediatric patients with serious CMV disease, patient survival during the first 3 post-transplant years was not different among the various CMV prophylaxis groups and was similar to patient survival in the control and at-large NAPRTCS renal transplant populations.…”

Section: Discussionsupporting

confidence: 43%

Cytomegalovirus infections following renal transplantation – effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Cooperative Study

Miller

et al. 1997

Pediatr Nephrol

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Post-transplant cytomegalovirus (CMV) infections are a source of significant morbidity. However, the extent of the problem and the benefits of various antiviral prophylactic therapies remain incompletely understood. The North American Pediatric Renal Transplant Cooperative Study registry was screened to identify patients hospitalized for CMV infections during the 1st post-renal transplant year between 1987 and 1993. Using a control group of transplant recipients, we performed a retrospective analysis of risk factors for CMV disease among these hospitalized patients and studied the effects of various viral prophylactic strategies on CMV risk, clinical manifestations, and outcome. We identified 142 patients hospitalized with CMV infections, the majority of which included major organ involvement. A CMV-positive kidney donor was the most significant risk factor for hospitalization [odds ratio (OR) = 5.2, P<0.0001] irrespective of recipient age or CMV immune status. As opposed to antiviral agents (acyclovir, ganciclovir) or pooled IgG, prophylaxis with enriched anti-CMV IgG significantly reduced the risk of CMV hospitalization (OR = 0.31, P = 0.03). The prophylactic use of antiviral agents was associated with a decreased risk of major organ involvement during the CMV infection (OR = 0.34, P<0.005). Among the patients with CMV, the 3-year graft survival was significantly better for those who received any form of prophylaxis compared with those who received none (88% vs. 52%, P<0.001). Our findings suggest a role for combined CMV-enriched IgG and antiviral agent prophylaxis for post-transplant CMV disease. Such an approach could diminish the incidence and severity of CMV infection and appears to have an independent favorable effect on graft outcome.

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Section: Discussionsupporting

confidence: 43%

Cytomegalovirus infections following renal transplantation – effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Cooperative Study

Miller

et al. 1997

Pediatr Nephrol

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Cytomegalovirus infection after organ transplantation: an update with special emphasis on renal transplantation

Son

The²

1989

Transplant Int

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Cytomegalovirus infections are still the most important infectious complications after organ transplantation. Besides historical notes this review will deal with new aspects concerning the epidemiology of the CMV, diagnostic modalities of CMV infection, the delicate counterbalance between the immune system and the CMV, as well as the symptomatology of this infection. Furthermore, aspects like prophylaxis and new, promising therapeutic regimes for treatment of infection will be dealt with. Although this update is applicable for all types of solid organ transplantation, emphasis will be on renal transplantation.

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Animal Models for Cytomegalovirus Infection

Stals

1999

Handbook of Animal Models of Infection

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The Effect of Cytomegalovirus Infection on Renal Allograft Function and Rejection in a Rat Model

Cited by 6 publications

References 0 publications

Cytomegalovirus infections following renal transplantation – effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Cooperative Study

Cytomegalovirus infections following renal transplantation – effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Cooperative Study

Cytomegalovirus infection after organ transplantation: an update with special emphasis on renal transplantation

Animal Models for Cytomegalovirus Infection

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