Open AccessClinical consequences of primary CMV infection after renal transplantation: a case–control study
Author(s) -
Singh Ramandeep,
PetersSengers Hessel,
Remmerswaal Ester B.M.,
Yapici Unsal,
Pant Karlijn A. M .I.,
Weerd Neelke C.,
Roelofs Joris J. T. H.,
Lier René A. W.,
Bemelman Fréderike J.,
Florquin Sandrine,
ten Berge Ineke J. M.
Publication year - 2020
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13667
Subject(s) - medicine , transplantation , kidney transplantation , hazard ratio , cytomegalovirus , retrospective cohort study , incidence (geometry) , gastroenterology , surgery , immunology , viral disease , virus , herpesviridae , confidence interval , physics , optics
Abstract The impact of primary cytomegalovirus infection (pCMV) on renal allograft function and histology is controversial. We evaluated the influence on incidence of acute rejection, allograft loss, allograft function and interstitial fibrosis/tubular atrophy (IF/TA). Retrospective case–control study, recipients transplanted between 2000 and 2014. Risk of acute rejection and allograft loss for those who experienced pCMV infection compared with those who did not, within an exposure period of two months after transplantation. Besides, its influence on allograft function and histology at one to three years after transplantation. Of 113 recipients experienced pCMV infection, 306 remained CMV seronegative. pCMV infection in the exposure period could not be proven as increasing the risk for acute rejection [HR = 2.18 (95% CI 0.80–5.97) P = 0.13] or allograft loss [HR = 1.11 (95%CI 0.33–3.72) P = 0.87]. Combination of pCMV infection and acute rejection posed higher hazard for allograft loss than acute rejection alone [HR = 3.69 (95% CI 1.21–11.29) P = 0.02]. eGFR(MDRD) values did not significantly differ at years one [46 vs. 50], two [46 vs. 51] and three [46 vs. 52]. No association between pCMV infection and IF/TA could be demonstrated [OR = 2.15 (95%CI 0.73–6.29) P = 0.16]. pCMV infection was not proven to increase the risk for acute rejection or allograft loss. However, it increased the risk for rejection‐associated allograft loss. In remaining functioning allografts, it was not significantly associated with decline in function nor with presence of IF/TA.