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. 2012 Jun;54(2):125-9.
doi: 10.1016/j.jcv.2012.02.020. Epub 2012 Mar 22.

Importance of the cytomegalovirus seropositive recipient as a contributor to disease burden after solid organ transplantation

Vincent C Emery  1 , Kevin Asher, Cristina de Juan Sanjuan
Affiliations

Importance of the cytomegalovirus seropositive recipient as a contributor to disease burden after solid organ transplantation

Vincent C Emery et al. J Clin Virol. 2012 Jun.

Abstract

Background: The incidence of cytomegalovirus (CMV) syndrome/disease after adult solid organ transplantation in the era effective antiviral therapy has not been fully assessed.

Objective: To determines the incidence of CMV syndrome/disease after solid organ transplantation in the UK.

Study design: A retrospective analysis of 1807 solid organ transplants from 12 UK solid organ transplant centres representing 32.7% of all transplant activity occurring in the UK between 1/04/2004 and 31/03/2006. Patients were categorised into those experiencing an episode of symptomatic CMV infection after transplant or those who remained free of symptoms. All patients were followed up for 2 years for the occurrence of CMV syndrome/disease.

Results: The majority of the transplant centres used valganciclovir prophylaxis in the high risk D+R- patients (91.6%) whereas management of the lower risk D+R+ and D-R+ patients was more variable with deployment of both prophylactic and pre-emptive strategies in ∼50% of centres. CMV syndrome/disease occurred in 20.5% of the D+R- patients representing 55 cases whereas the incidence was only 8.1% and 9% in the D+R+ and D-R+ group, respectively (p<0.001 compared to the D+R- group), but representing a further 58 cases of CMV syndrome/disease. CMV viraemia in the D+R- group was associated with a high probability (65%) of CMV syndrome/disease in renal transplant recipients whereas this was less apparent in the intermediate risk groups.

Conclusions: CMV syndrome/disease remains an important healthcare burden after solid organ transplantation with the intermediate risk groups contributing similar numbers of cases as the high risk group.

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