The impact of early cytomegalovirus infection after kidney transplantation on long-term graft and patient survival.

Abstract

This prospective observational cohort study is an extension of a previous study reporting effects of cytomegalovirus (CMV) on graft and patient survival in 471 patients who underwent kidney transplantation between 1994 and 1997. CMV pp65 antigen was measured every 7-14 d during the first three months after transplantation, given as number of CMV pp65-positive cells per 10(5) leukocytes. A positive test was defined as CMV infection. None of the patients received CMV prophylaxis or preemptive treatment. During a median of 13.7 (7.1-14.9) yr, the number of death-censored graft losses was 118 (25%) and of patient deaths 224 (48%). CMV infection was an independent significant risk factor for mortality in multivariate analysis (HR = 1.453, 95% CI 1.033-2.045, p = 0.032), adjusting for patient and donor age, preemptive transplantation, HLA-DR and -AB mismatches, living donor, acute rejection during the first three months, donor-recipient CMV IgG antibody status and diabetic nephropathy. In univariate analysis, CMV infection was significantly associated with death-censored graft loss but the association was not significant in multivariate model. CMV infection early after kidney transplantation is a predictor of overall mortality but not of death-censored graft loss after a median observation period of 13.7 yr.

• Authors: Yuliya V Smedbråten, Solbjørg Sagedal, Torbjørn Leivestad, Geir Mjøen, Kåre Osnes, Halvor Rollag, Anna V Reisaeter, Aksel Foss, Ingrid Os, Anders Hartmann
• Journal: Clinical transplantation (Clin Transplant) Vol. 28 Issue 1 Pg. 120-6 (Jan 2014) ISSN: 1399-0012 [Electronic] Denmark
• PMID: 24351078 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Phosphoproteins
• Viral Matrix Proteins
• cytomegalovirus matrix protein 65kDa

Topics

• Adolescent
• Adult
• Cytomegalovirus (pathogenicity)
• Cytomegalovirus Infections (etiology, mortality)
• Female
• Follow-Up Studies
• Glomerular Filtration Rate
• Graft Rejection (etiology, mortality)
• Graft Survival (physiology)
• Humans
• Kidney Failure, Chronic (surgery)
• Kidney Function Tests
• Kidney Transplantation
• Male
• Middle Aged
• Phosphoproteins (blood)
• Postoperative Complications
• Prognosis
• Prospective Studies
• Risk Factors
• Survival Rate
• Viral Matrix Proteins (blood)
• Young Adult