Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 4:3:1370945.
doi: 10.3389/frtra.2024.1370945. eCollection 2024.

High burden of CMV infections after simultaneous pancreas-kidney transplantation-a nationwide cohort study

Kaisa Ahopelto  1 , Juulia Grasberger  2 , Fernanda Ortiz  2 , Agneta Ekstrand  2 , Arno Nordin  1 , Marko Lempinen  1 , Ilkka Helanterä  1
Affiliations

High burden of CMV infections after simultaneous pancreas-kidney transplantation-a nationwide cohort study

Kaisa Ahopelto et al. Front Transplant. .

Abstract

Cytomegalovirus (CMV) infections remain a common problem after solid-organ transplantation. We characterized the burden of CMV infections, and adverse events of CMV prophylaxis after simultaneous pancreas-kidney transplantation (SPK). We included all SPK patients (n = 236) since 2010 in our country. Immunosuppression was ATG, tacrolimus, mycophenolate, and steroids. Valganciclovir prophylaxis was given to all CMV D+/R- patients for six months, and to seropositive SPK patients for three months since February 2019. CMV DNAemia was monitored with quantitative PCR from plasma. Among D+/R- SPK recipients, post prophylaxis CMV infection was detected in 41/60 (68%) during follow-up. In seropositive SPK recipients with no prophylaxis, CMV infection was detected in 53/95 (56%), vs. 28/78 (36%) in those who received 3 months of prophylaxis (P = 0.01). CMV was symptomatic in 35 (15%) patients, of which 10 required hospitalization. Mean duration of viremia was 28 days (IQR 21-41). Leukopenia was detected in 63 (46%) of the 138 patients with valganciclovir prophylaxis. 7/122 (6%) of the CMV infections detected were defined as refractory to treatment, and three patients had confirmed ganciclovir resistance. SPK recipients experience a high burden of CMV infections despite CMV prophylaxis. Leukopenia is common during valganciclovir prophylaxis.

Keywords: CMV; SPK; kidney transplantation; pancreas transplantation; valganciclovir.

PubMed Disclaimer

Conflict of interest statement

The following authors have received speaker's fees from Astellas Pharma (KA, IH, ML, FO), Sandoz (IH, ML), Novartis (ML), Hansa Biopharma (KA, IH), Takeda (IH). IH holds research grant from MSD and Hansa Biopharma, and has ongoing consultancy agreements with MSD, Novartis, Hansa Biopharma, and Takeda. FO received consultancy honoraria from GSK, Sandoz, and STADA. AE serves on the advisory board of Baxter, Sanofi-Genzyme, Astra-Zeneca, and Vifor Pharma. ML Serves on the advisory board of Sandoz. The remaining 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.

Similar articles

See all similar articles

Cited by

References

    1. Helanterä I, Schachtner T, Hinrichs C, Salmela K, Kyllönen L, Koskinen P, et al. Current characteristics and outcome of cytomegalovirus infections after kidney transplantation. Transpl Infect Dis. (2014) 16(4):568–77. 10.1111/tid.12247 - DOI - PubMed
    1. Helanterä I, Kyllönen L, Lautenschlager I, Salmela K, Koskinen P. Primary CMV infections are common in kidney transplant recipients after 6 months valganciclovir prophylaxis. Am J Transplant. (2010) 10(9):2026–32. 10.1111/j.1600-6143.2010.03225.x - DOI - PubMed
    1. Räihä J, Ortiz F, Mannonen L, Loginov R, Lempinen M, Lautenschlager I, et al. The burden of cytomegalovirus infection remains high in high-risk kidney transplant recipients despite six-month valganciclovir prophylaxis. Transpl Infect Dis. (2021) 23(4):e13577. 10.1111/tid.13577 - DOI - PubMed
    1. Emery VC, Asher K, Sanjuan C. Importance of the cytomegalovirus seropositive recipient as a contributor to disease burden after solid organ transplantation. J Clin Virol. (2012) 54(2):125–9. 10.1016/j.jcv.2012.02.020 - DOI - PMC - PubMed
    1. Dean PG, Kukla A, Stegall MD, Kudva YC. Pancreas transplantation. Br Med J. (2017) 357:j1321. 10.1136/bmj.b1321 - DOI - PubMed

LinkOut - more resources