Cytomegalovirus Infection in Kidney Transplant Recipients

Abstract

Introduction: Present study examined the frequency of CMV infection during follow-up using quantitative nucleic acid amplification testing, the frequency of administration of infection prophylaxis, viremia and infection in kidney transplant recipients who underwent transplantation (TX) at the University Hospital Center Osijek. Materials and Methods: 107 kidney recipients who underwent transplantation in the period 20 October 2007 – 24 August 2016 were included. Demographic and clinical data, data about pre-transplantation CMV IgG test results of recipients and their donors, data about CMV prophylaxis, viremia, infection, and kidney transplant function were taken from medical records and analyzed. Results: 92.5% of kidney recipients and 86% of donors were CMV IgG positive before TX. 28% of recipients were CMV-DNA positive at some point after TX, none of whom received a transplant from an IgG negative donor. 89.7% of participants received CMV prophylaxis. Seven participants developed CMV disease, 2 of whom were not administered prophylaxis. Participants were tested for CMV-DNA once a year (median; min 0 max 6). CMV disease was marginally more frequent in those who did not receive valganciclovir prophylaxis (P = 0.066). Conclusion: It seems wise to enforce the administration of CMV prophylaxis and CMV-DNA testing in accordance with protocol, in order to detect viremia on time and to implement preemptive treatment, aiming at prevention of clinical manifestation of infection and preservation of graft function.

Keywords

• cytomegalovirus
• kidney transplantation
• cmv-dna
• prophylaxis
• valganciclovir