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Latent cytomegalovirus infection is an independent risk factor for late graft failure in renal transplant recipients.

van Ree RM, de Vries AP, Zelle DM, de Vries LV, Oterdoom LH, Gans RO, Schouten JP, Lems SP, van Son WJ, Bakker SJ - Med. Sci. Monit. (2011)

Bottom Line: CMV serology was determined using ELISA.We measured CMV IgG at 6.0 [2.6-11.4] years post-transplant.These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.

View Article: PubMed Central - PubMed

Affiliation: Renal Transplant Program, University Medical Center Groningen and University of Groningen, The Netherlands.

ABSTRACT

Background: Cytomegalovirus (CMV) is a risk factor for rejection and mortality soon after renal transplantation. Little is known about its consequences longer after transplantation. We prospectively investigated whether latent CMV infection is a risk factor for graft failure and mortality long after transplantation.

Material/methods: Our study included 606 renal transplant recipients (RTR) with a functioning graft for >1 year. CMV serology was determined using ELISA. RTRs were divided into CMV-seronegative and latent CMV (seropositive + seroconverted).

Results: We measured CMV IgG at 6.0 [2.6-11.4] years post-transplant. During follow-up (7.0 [6.2-7.5] years), 54 (9%) RTRs experienced graft failure and 137 (23%) RTRs died. Risk for graft failure and mortality was significantly higher in RTRs with latent CMV compared to CMV-seronegative RTRs (HR=3.1, P=0.005 and HR=2.0, P=0.002, respectively). After adjustment for potential confounders, latent CMV infection remained an independent risk factor for graft failure (HR=4.6, P=0.001), but not for mortality (HR=1.4, P=0.2).

Conclusions: Latent CMV is an independent risk factor for graft failure long after renal transplantation and carries a higher risk for graft failure than for mortality. These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.

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Related in: MedlinePlus

Kaplan-Meier analysis of (A) graft and (B) RTR survival according to CMV serostatus >1 year after transplantation. Tested with log-rank test.
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f1-medscimonit-17-11-cr609: Kaplan-Meier analysis of (A) graft and (B) RTR survival according to CMV serostatus >1 year after transplantation. Tested with log-rank test.

Mentions: Median follow-up was 7.0 (6.2–7.5) years both for graft failure and mortality. During follow-up, 54 (9%) RTRs experienced graft failure and 137 (23%) RTRs died. In the CMV-seronegative group, 7 (4%) RTRs experienced graft failure and 25 (14%) died, while these numbers were 17 (11%) and 35 (23%) for the CMV-seroconverted RTRs and 30 (9%) and 77 (28%) for the CMV-seropositive RTRs (both log-rank test: P<0.02, Figure 1A, B).


Latent cytomegalovirus infection is an independent risk factor for late graft failure in renal transplant recipients.

van Ree RM, de Vries AP, Zelle DM, de Vries LV, Oterdoom LH, Gans RO, Schouten JP, Lems SP, van Son WJ, Bakker SJ - Med. Sci. Monit. (2011)

Kaplan-Meier analysis of (A) graft and (B) RTR survival according to CMV serostatus >1 year after transplantation. Tested with log-rank test.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539501&req=5

f1-medscimonit-17-11-cr609: Kaplan-Meier analysis of (A) graft and (B) RTR survival according to CMV serostatus >1 year after transplantation. Tested with log-rank test.
Mentions: Median follow-up was 7.0 (6.2–7.5) years both for graft failure and mortality. During follow-up, 54 (9%) RTRs experienced graft failure and 137 (23%) RTRs died. In the CMV-seronegative group, 7 (4%) RTRs experienced graft failure and 25 (14%) died, while these numbers were 17 (11%) and 35 (23%) for the CMV-seroconverted RTRs and 30 (9%) and 77 (28%) for the CMV-seropositive RTRs (both log-rank test: P<0.02, Figure 1A, B).

Bottom Line: CMV serology was determined using ELISA.We measured CMV IgG at 6.0 [2.6-11.4] years post-transplant.These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.

View Article: PubMed Central - PubMed

Affiliation: Renal Transplant Program, University Medical Center Groningen and University of Groningen, The Netherlands.

ABSTRACT

Background: Cytomegalovirus (CMV) is a risk factor for rejection and mortality soon after renal transplantation. Little is known about its consequences longer after transplantation. We prospectively investigated whether latent CMV infection is a risk factor for graft failure and mortality long after transplantation.

Material/methods: Our study included 606 renal transplant recipients (RTR) with a functioning graft for >1 year. CMV serology was determined using ELISA. RTRs were divided into CMV-seronegative and latent CMV (seropositive + seroconverted).

Results: We measured CMV IgG at 6.0 [2.6-11.4] years post-transplant. During follow-up (7.0 [6.2-7.5] years), 54 (9%) RTRs experienced graft failure and 137 (23%) RTRs died. Risk for graft failure and mortality was significantly higher in RTRs with latent CMV compared to CMV-seronegative RTRs (HR=3.1, P=0.005 and HR=2.0, P=0.002, respectively). After adjustment for potential confounders, latent CMV infection remained an independent risk factor for graft failure (HR=4.6, P=0.001), but not for mortality (HR=1.4, P=0.2).

Conclusions: Latent CMV is an independent risk factor for graft failure long after renal transplantation and carries a higher risk for graft failure than for mortality. These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.

Show MeSH
Related in: MedlinePlus