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. 2023 Apr 1;107(4):988-993.
doi: 10.1097/TP.0000000000004352. Epub 2022 Sep 29.

Increasing Proportion of High-risk Cytomegalovirus Donor-positive/Recipient-negative Serostatus in Solid Organ Transplant Recipients

Hannah Imlay  1 , Marilyn M Wagener  2 , Philip Vutien  3 , James Perkins  3 , Nina Singh  2 , Ajit P Limaye  4
Affiliations

Increasing Proportion of High-risk Cytomegalovirus Donor-positive/Recipient-negative Serostatus in Solid Organ Transplant Recipients

Hannah Imlay et al. Transplantation. .

Abstract

Background: Cytomegalovirus (CMV) donor-positive/recipient-negative (D+R-) serostatus is independently associated with worse allograft and patient survival across solid organ transplant (SOT) types. We characterized trends in CMV D+R- serostatus among adult SOT recipients performed in the United States.

Methods: Donor (D) and recipient (R) CMV serostatus and demographic factors were obtained from the Scientific Registry of Transplant Recipients for persons ≥18 y undergoing a first SOT between January 1, 2000, and December 31, 2020. The proportions of D+R- SOTs over time were assessed using Chi square for trend and modeled through 2040. Factors associated with D/R seropositivity were assessed using logistic models.

Results: Among 472 549 SOTs, the average proportion of D+R- SOTs increased significantly among kidney, liver, heart, and lung between 2000 to 2009 and 2010 to 2020: 18.0% to 18.3% ( P = 0.034), 19.4% to 21.8% ( P < 0.001), 22.2% to 25.5% ( P < 0.001), and 23.6% to 27.0% ( P < 0.001), respectively. The increased proportion over time resulted from a disproportionate increase in R- (34.9% to 37.0% for all organ types, P < 0.001) and a smaller corresponding change in D+ (60.8% to 60.3%, P < 0.001).

Conclusions: The proportion of high-risk CMV D+R- SOTs increased significantly across all organs and is projected to continue to increase. These findings inform population-level strategies to mitigate the negative impact of CMV D+R- in SOT.

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Conflict of interest statement

A.P.L. has received consulting fees, research support, contracted research, or consulting fees from: Amplyx Pharmaceuticals, Novartis, Merck, J&J, NovoNordisc, GSK, NobelPharma, Hologic, and Allovir. The other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Trends in CMV serostatus across kidney, liver, heart, and lung transplantation. A and B, Temporal trends in CMV donor and recipient serostatus among kidney recipients. C and D, Temporal trends in CMV donor and recipient serostatus among liver recipients. E and F, Temporal trends in CMV donor and recipient serostatus among heart recipients. G and H, Temporal trends in CMV donor and recipient serostatus among lung recipients. CMV, cytomegalovirus; D+R-, donor positive recipient negative.
Figure 1.
Figure 1.
Trends in CMV serostatus across kidney, liver, heart, and lung transplantation. A and B, Temporal trends in CMV donor and recipient serostatus among kidney recipients. C and D, Temporal trends in CMV donor and recipient serostatus among liver recipients. E and F, Temporal trends in CMV donor and recipient serostatus among heart recipients. G and H, Temporal trends in CMV donor and recipient serostatus among lung recipients. CMV, cytomegalovirus; D+R-, donor positive recipient negative.
Figure 1.
Figure 1.
Trends in CMV serostatus across kidney, liver, heart, and lung transplantation. A and B, Temporal trends in CMV donor and recipient serostatus among kidney recipients. C and D, Temporal trends in CMV donor and recipient serostatus among liver recipients. E and F, Temporal trends in CMV donor and recipient serostatus among heart recipients. G and H, Temporal trends in CMV donor and recipient serostatus among lung recipients. CMV, cytomegalovirus; D+R-, donor positive recipient negative.
Figure 1.
Figure 1.
Trends in CMV serostatus across kidney, liver, heart, and lung transplantation. A and B, Temporal trends in CMV donor and recipient serostatus among kidney recipients. C and D, Temporal trends in CMV donor and recipient serostatus among liver recipients. E and F, Temporal trends in CMV donor and recipient serostatus among heart recipients. G and H, Temporal trends in CMV donor and recipient serostatus among lung recipients. CMV, cytomegalovirus; D+R-, donor positive recipient negative.
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References

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