CMV viraemia in kidney transplantation; Risk factors and outcomes in the era of prophylaxis

Abstract

Background Cytomegalovirus (CMV) is among the most prevalent opportunistic pathogens sequencing solid-organ transplantation. Viral immunomodulatory effect can result in the deleterious indirect impacts of CMV over the patient and the graft. The aim of this work was to study the risk factors and the outcomes of CMV viremia in kidney-transplantation recipients. Patients and methods Via a retrospective cohort analysis, we tracked 320 kidney-transplantation recipients’ archives who had their kidney grafts from the beginning of January 2008 to the end of December 2013. The data of 307 recipients were recorded. The study groups were tracked for 10 years post kidney transplantation for the cumulative incidence of CMV viremia, possible risk factors, and incidence of significant post-transplant clinical events. Results One-hundred twenty-seven recipients were CMV-positive, with the first year’s cumulative incidence 36.3% post kidney transplantation. The recipient’s age, pretransplant hypertension, and CMV serostatus mismatch were independent CMV viremia risk factors. CMV was not an independent predictor for the decreased patient survival in this study, but was associated with a significantly reduced graft function as assessed by estimated glomerular-filtration rate. Conclusion Screening, prophylaxis, and prompt treatment have negated the negative outcomes of CMV viremia on patient and graft survival.