Cytomegalovirus Disease in Renal Allograft Recipients in the Current Immunosuppression Era

Abstract

The high prevalence of cytomegalovirus (CMV) after kidney transplantation, along with its significant morbidity, mortality, and financial burden, makes it a serious infectious complication. This retrospective observational study aimed to determine the incidence of CMV infection and recurrence in renal transplant recipients during the era of immunosuppression (IS), and to identify modifiable predictors of CMV infection. A total of 233 patients were screened for CMV disease incidence and predictors and were prospectively followed. The incidence of CMV disease was found to be 14.6% (95% CI, 11.7%−18%), with no recurrence observed. Multivariate analysis revealed that factors such as CMV serostatus and a positive B-cell crossmatch at transplantation were associated with an increased risk of CMV. Specifically, patients with a positive B-cell crossmatch had a threefold higher risk of developing CMV compared to those with a negative crossmatch (p = 0.025). This association is a novel finding and should be considered when assessing risks and complications in patients. There was a lower incidence of CMV infection among kidney transplant recipients within the first 2−5 years after transplantation. A positive B-cell crossmatch at the time of transplantation was strongly associated with an increased risk of developing CMV disease.