Does the cytomegalovirus infection cause kidney transplant rejection in Erbil city patients, Kurdistan region of Iraq?

Abstract

Cytomegalovirus (CMV), the most significant infectious agent, belongs to the family of Herpesviridae. There is a high risk of severe viral reactivation among patients with kidney transplantation, particularly in the first three months after transplantation (where patients are at the peak for immune suppression), The infection has a high morbidity rate. Hence, this study was designed to assess the association of CMV infection with kidney transplantation and recognize the symptoms that are more related to kidney transplantation (KT) in the Erbil city, Kurdistan region of Iraq. The study enrolled 72 patients who received renal allograft from March 2018 to December 2019, and this population has been characterized as Middle Eastern descent and ethnic miscegenation. Data included age and gender of the recipient, type of donor, symptomatic and asymptomatic CMV patients. Quantitative Polymerase Chain Reaction (qPCR) was used to detect and amplify the extracted virus DNA from blood samples. The CMV was found in 43 patients infected with CMV with graft rejection of about 37.21%. While, it was observed in low rate 13.79% in 20 other patients with graft rejection which had free from CMV. The graft rejection rates were significantly higher among the CMV positive group than controls (P= 0.029). In the light of the results of this study, it has been concluded that the CMV infection in patients after kidney transplantation surgery was deemed an important predisposing factor for acute allograft rejection. The study revealed that the screening of CMV among donor could decrease the possibility of kidney graft rejection among recipients.

Keywords

• allograft rejection
• inflammation
• cytomegalovirus
• kidney transplantation
• polymerase chain reaction