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. 2023 Jun 13:13:1190794.
doi: 10.3389/fcimb.2023.1190794. eCollection 2023.

Long-term CMV monitoring and chronic rejection in renal transplant recipients

Shoko Ishikawa  1 , Masayuki Tasaki  1 , Kazuhide Saito  1 , Yuki Nakagawa  1   2 , Masahiro Ikeda  1 , Kota Takahashi  3 , Yoshihiko Tomita  1
Affiliations

Long-term CMV monitoring and chronic rejection in renal transplant recipients

Shoko Ishikawa et al. Front Cell Infect Microbiol. .

Abstract

Introduction: Cytomegalovirus (CMV) is well established to be an independent risk factor for graft loss after kidney transplantation (KTx). Monitoring for CMV in the chronic phase is not defined in the current guideline. The effects of CMV infection, including asymptomatic CMV viremia, in the chronic phase are unclear.

Methods: We performed a single-center retrospective study to investigate incidence of CMV infection in the chronic phase, defined as more than 1 year after KTx. We included 205 patients who received KTx between April 2004 and December 2017. The CMV pp65 antigenemia assays to detect CMV viremia were continuously performed every 1-3 months.

Results: The median duration of the follow-up was 80.6 (13.1-172.1) months. Asymptomatic CMV infection and CMV disease were observed in 30.7% and 2.9% in the chronic phase, respectively. We found that 10-20% of patients had CMV infections in each year after KTx which did not change over 10 years. The history of CMV infection in the early phase (within 1 year after KTx) and chronic rejection were significantly associated with CMV viremia in the chronic phase. CMV viremia in the chronic phase was significantly associated with graft loss.

Discussion: This is the first study to examine the incidence of CMV viremia for 10 years post KTx. Preventing latent CMV infection may decrease chronic rejection and graft loss after KTx.

Keywords: CMV; chronic rejection; kidney transplantation; long-term; monitoring.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Maximum value of CMV-Ag in each year after transplantation.
Figure 2
Figure 2
Ratio of patients who experienced CMV-Ag and were treated for CMV infection in each year after transplantation.
Figure 3
Figure 3
Comparison of the maximum value of CMV-Ag between treated and untreated patients.
Figure 4
Figure 4
Timing of CMV infection in patients that received rejection therapies (n = 15).
See this image and copyright information in PMC

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