Between January 2000 and December 2006, 318 kidney transplants were performed in our unit.
Cytomegalovirus infection in transplanted patients causes both direct and indirect effects on other organ systems, including acute allograft rejection and decreased graft and patient survival. The aim of our study was to evaluate the incidence of
cytomegalovirus infection after
kidney transplantation, the treatment strategies, and the impact of
cytomegalovirus infection on allograft function and survival. Those patients who at least once were treated for
cytomegalovirus infection were assigned to the study group (n=102). The control group included the remaining patients (n=216) in whom
kidney transplantation was performed between January 2000 and December 2006. The mean age of the recipients in both groups was 39.8+/-12.8 years (range 15-60) and 38.5+/-12.6 years (range 7-66), respectively; retransplantations and acute allograft rejections were more common in the group treated for
cytomegalovirus infection: 13 (12.7%) vs. 18 (8.3%) and 55 (53.9%) vs. 103 (47.2%), respectively. Between January 2000 and December 2006, the total number of
cytomegalovirus infection episodes was 167. The greatest number of
cytomegalovirus infection episodes occurred during the first 1-3 months after
transplantation and accounted for 27.5%; during 3-6 months, 17.4%; during 6-12 months, 18.6%. Serum
creatinine levels were higher in our study group.
Cytomegalovirus infection manifested as
pneumonitis in 26.5% and as gastrointestinal tract disorders in 9.8% of cases; 3.9% of patients were treated for
encephalitis. Patients in the study group reported more frequently other
infections: bacterial infections, 66 (64.7%) vs. 116 (53.7%);
virus infections, 2 (2%) vs. 3 (1.4%); and mixed bacterial-
virus infections, 8 (7.8%) vs. 4 (1.9%). The number of patients who did not experience any
infection was higher in control group: 26 (25.5%) vs. 93 (43.1%). Death from
cytomegalovirus infection occurred in 15 (14.7%) of the 102 patients in the study group.