BACKGROUND AND OBJECTIVE: Cytomegalovirus (CMV) is one of the most important pathogens in renal transplant patients. It can cause infection and illness, as well as serious direct and indirect consequences. PATIENTS AND METHOD: Descriptive retrospective observational study of all kidney transplants performed in the Hospital La Fe of Valencia between 1994 and 2005 (n=996). The diagnosis of CMV disease and disease was performed by serology, culture, pp65 antigenemia determination or quantification of CMV-PCR (polymerase chain reaction) in peripheral blood. Prophylaxis included acyclovir in 20 patients (2.4%), ganciclovir in 478 (56.8%), valganciclovir in 166 (19.7%) and none in 178 (21%). RESULTS: CMV serology was positive in 802 donors (83%) and in 860 recipients (89%). Among the recipients who suffered from CMV disease (N=60), four lost the graft and six died. Early infection and early disease were significantly more frequent (p<0.05) in positive donor-negative recipient cases (D+/R-). Having early or late infection was associated with death from any cause (OR 2.03, CI 95% 1.24 to 3.31, p<0.05). Early or late CMV infection was associated with increased graft loss from any cause (OR 1.97, CI 95% 1.14 to 3.43, p<0.05). After logistic regression, the association between CMV infection and death from all causes remained significant. CONCLUSIONS: In renal transplant patients, having CMV infection was associated with death from any cause.
BACKGROUND AND OBJECTIVE: Cytomegalovirus (CMV) is one of the most important pathogens in renal transplant patients. It can cause infection and illness, as well as serious direct and indirect consequences. PATIENTS AND METHOD: Descriptive retrospective observational study of all kidney transplants performed in the Hospital La Fe of Valencia between 1994 and 2005 (n=996). The diagnosis of CMV disease and disease was performed by serology, culture, pp65 antigenemia determination or quantification of CMV-PCR (polymerase chain reaction) in peripheral blood. Prophylaxis included acyclovir in 20 patients (2.4%), ganciclovir in 478 (56.8%), valganciclovir in 166 (19.7%) and none in 178 (21%). RESULTS: CMV serology was positive in 802 donors (83%) and in 860 recipients (89%). Among the recipients who suffered from CMV disease (N=60), four lost the graft and six died. Early infection and early disease were significantly more frequent (p<0.05) in positive donor-negative recipient cases (D+/R-). Having early or late infection was associated with death from any cause (OR 2.03, CI 95% 1.24 to 3.31, p<0.05). Early or late CMV infection was associated with increased graft loss from any cause (OR 1.97, CI 95% 1.14 to 3.43, p<0.05). After logistic regression, the association between CMV infection and death from all causes remained significant. CONCLUSIONS: In renal transplant patients, having CMV infection was associated with death from any cause.