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. 2019 Dec;21(6):e13106.
doi: 10.1111/tid.13106. Epub 2019 Oct 29.

Incidence and risk factors associated with cytomegalovirus infection after the treatment of acute rejection during the first year in kidney transplant recipients receiving preemptive therapy

Claudia Felipe  1 , Alexandra Nicolau Ferreira  1 , Mayara de Paula  1 , Laila Viana  1 , Marina Cristelli  1 , Jose Medina Pestana  1 , Helio Tedesco-Silva  1
Affiliations

Incidence and risk factors associated with cytomegalovirus infection after the treatment of acute rejection during the first year in kidney transplant recipients receiving preemptive therapy

Claudia Felipe et al. Transpl Infect Dis. 2019 Dec.

Abstract

Introduction: The complex interaction between cytomegalovirus (CMV) infection and acute rejection after kidney transplantation is well recognized.

Methods: This single center retrospective cohort analysis investigated the incidence and risk factors associated with CMV infection after treatment for acute rejection (tAR) in kidney transplant recipients receiving only CMV preemptive therapy. Of the 938 kidney transplants performed between 04/30/2014 and 04/30/2015 we identified 87 (9.3%) that were treated for acute rejection within the first year.

Results: Most patients (64%) received rATG induction therapy followed by tacrolimus in combination with azathioprine (67%) or mycophenolate (33%) and corticosteroids. The incidence of CMV infection/disease after tAR was 47%, of which 73% occurred within 30 days. Using multivariable logistic regression analysis, eGFR at 1 month (OR = 0.98; 95% CI, 0.97-0.99; P = 0.007) and timing of tAR (OR = 0.98; 95% CI, 0.96-0.99; P = 0.021) were independently associated with CMV infection/disease after tAR.

Conclusion: In this cohort of kidney transplant recipients receiving tacrolimus-based immunosuppressive and preemptive CMV therapy, almost 50% developed CMV infection/disease after tARin the first year of transplantation. Early rejection and poor initial renal function were risk factors associated with CMV infection or disease.

Keywords: acute rejection; cytomegalovirus; kidney transplant.

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References

REFERENCES

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