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. 2008 Feb;41(2):92-5.
doi: 10.1016/j.jcv.2007.10.006. Epub 2007 Nov 26.

Donor and recipient CMV serostatus and antigenemia after renal transplantation: an analysis of 486 patients

David Hughes  1 , John Hafferty, Lee Fulton, Peter Friend, Andrea Devaney, Justin Loke, Ken I Welsh, Ashok Handa, Paul Klenerman
Affiliations

Donor and recipient CMV serostatus and antigenemia after renal transplantation: an analysis of 486 patients

David Hughes et al. J Clin Virol. 2008 Feb.

Abstract

Background: Cytomegalovirus infection in renal transplant recipients is a major clinical problem, with both short and long term sequelae. Infection can occur as a result of reactivation of latent virus or new infection from donor tissues. The impact of donor and recipient serostatus on viremia is well recognised, with seronegative recipients at greatest risk after transplantation of an organ from a seropositive donor. However, the impact of grafting such organs into seropositive recipients is less clear.

Objectives: To assess the impact of recipient serostatus on the risk of CMV antigenemia in a large renal transplant cohort.

Study design: We prospectively quantified CMV antigenemia over time in a cohort of 486 recipients. We analysed the antigenemia status according to donor and recipient serostatus.

Results: Antigenemia was most common in seronegative recipients of organs from seropositive donors (D+/R-). Nevertheless, we observed that even in CMV seropositive recipients, the impact of donor serostatus on CMV antigenemia is still substantial (p=0.006; OR=2.2).

Conclusions: In this large study, donor serostatus clearly plays a significant role in determining CMV risk, even in seropositive recipients.

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Figures

Fig. 1
Fig. 1
Comparison of CMV antigenemia rates in different clinical risk groups. The upper panel (A) shows the proportion of individuals experiencing CMV antigenemia over the follow-up period in the four different clinical groups. The lower panel (B) shows the frequency of antigenemia at a level >5/50,000 over the same period. The mean onset of antigenemia did not differ between the different groups. The p value refers to the impact of donor serostatus in the seropositive recipient group. Other p values for these comparisons are shown in Table 2.
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