Four-year experience with exclusive use of cytomegalovirus antibody (CMV-Ab)-negative donors for CMV-Ab-negative kidney recipients.

Because of unacceptable CMV related morbidity, mortality, and graft loss, we adopted a policy that (-) patients would receive renal allografts only from (-) donors. This policy has resulted in a significant decrease in (1) morbidity (10.6% v 1.7%, P less than .0001), (2) mortality (3.7%) v 0%, P = .002), and (3) graft loss (2.5% v 0%, P = .016). CMV-Ab-negative patients (1) constitute 26% of all patients tested (compared with 36% of all donors tested), (2) receive transplants at the same rate as (+) patients, (3) do not have a prolonged waiting time, and (4) received greater HLA-A, B, -DR mismatched kidneys (3.6 v 3.1, P less than .01).