María Ovidia López-Oliva1, Julio Flores2, Rosario Madero3, Fernando Escuin4, María José Santana4, Teresa Bellón5, Rafael Selgas4, Carlos Jiménez4. 1. Servicio de Nefrología, Hospital Universitario La Paz-IdiPaz, Madrid, España. Electronic address: mlopezo@salud.madrid.org. 2. Servicio de Nefrología, Hospital Rosales, San Salvador, El Salvador. 3. Sección de Bioestadística, Hospital Universitario La Paz-IdiPaz, Madrid, España. 4. Servicio de Nefrología, Hospital Universitario La Paz-IdiPaz, Madrid, España. 5. Instituto de Investigación sanitaria. Hospital Universitario La Paz-IdiPaz, Madrid, España.
Abstract
BACKGROUND: Despite the use of prevention strategies, cytomegalovirus (CMV) infection is the most common viral complication after renal transplant and its impact on long-term outcomes is still open to debate. OBJECTIVE: To evaluate the incidence of CMV infection and disease during the use of prevention strategies in our centre and to analyse the association between CMV infection and long-term patient and graft survival and other potentially clinical events related with CMV. METHODS: We reviewed the medical records of 377 recipients of kidney transplants performed between January 1998 and December 2008. Kaplain-Meier survival curve analysis was performed to analyse graft and patient survival by CMV infection/disease and Cox proportional hazards regression was used to identify factors associated with CMV infection/disease, graft loss and mortality. RESULTS: The incidence of CMV infection was 34.7% and CMV disease was 9.5%. Patient and graft survival was significantly lower in patients with CMV infection/disease. CMV infection/disease was associated with a higher risk of graft loss (HR 1.91, 95% CI 1.09-3.36, p=0.023), but not with a higher mortality (HR 1.29, 95% CI 0.7-2.38, p=0.4). CONCLUSION: CMV replication after renal transplant is a risk factor for long-term graft loss but not mortality. Prevention strategies decrease post-transplant CMV infection and disease.
BACKGROUND: Despite the use of prevention strategies, cytomegalovirus (CMV) infection is the most common viral complication after renal transplant and its impact on long-term outcomes is still open to debate. OBJECTIVE: To evaluate the incidence of CMV infection and disease during the use of prevention strategies in our centre and to analyse the association between CMV infection and long-term patient and graft survival and other potentially clinical events related with CMV. METHODS: We reviewed the medical records of 377 recipients of kidney transplants performed between January 1998 and December 2008. Kaplain-Meier survival curve analysis was performed to analyse graft and patient survival by CMV infection/disease and Cox proportional hazards regression was used to identify factors associated with CMV infection/disease, graft loss and mortality. RESULTS: The incidence of CMV infection was 34.7% and CMV disease was 9.5%. Patient and graft survival was significantly lower in patients with CMV infection/disease. CMV infection/disease was associated with a higher risk of graft loss (HR 1.91, 95% CI 1.09-3.36, p=0.023), but not with a higher mortality (HR 1.29, 95% CI 0.7-2.38, p=0.4). CONCLUSION: CMV replication after renal transplant is a risk factor for long-term graft loss but not mortality. Prevention strategies decrease post-transplant CMV infection and disease.
Authors: Gabriele Prospero Nakamura; Renata Mendonça Moraes; Juliana Mota Siqueira; Andrea Cruz Ferraz de Oliveira; Maria Dirlei Ferreira de Souza Begnami; Graziella Chagas Jaguar Journal: Autops Case Rep Date: 2019-01-14
Authors: Ana C López Giuliani; Eva Hernández; María J Tohmé; Clémence Taisne; Julieta S Roldán; Clara García Samartino; Marion Lussignol; Patrice Codogno; María I Colombo; Audrey Esclatine; Laura R Delgui Journal: Front Cell Infect Microbiol Date: 2020-09-15 Impact factor: 5.293