Prevention of cytomegalovirus-related death by passive immunization. A double-blind placebo-controlled study in kidney transplant recipients treated for rejection.
In a double-blind placebo-controlled study, the value of prophylactic anti-CMV immunoglobulin administration was evaluated in 39 kidney transplant recipients treated for rejection with rabbit antithymocyte globulin. Passive immunization completely prevented CMV-related death, although it did not reduce the incidence of CMV isolation, viremia, or disease. The effect of passive immunization was exclusively observed in CMV-seronegative recipients of a CMV-seropositive kidney donor. It could be demonstrated even when instituted when antirejection therapy was started. Seropositive recipients did not benefit from immunoglobulin treatment. Moreover, CMV-seronegative recipients of a kidney from a seronegative donor were not at risk for CMV infection at all. Therefore passive immunization should be restricted to seronegative recipients of seropositive allograft donors treated for rejection.
Metselaar
H J
HJ
Department of Internal Medicine, University Hospital Rotterdam, Dijkzigt, The Netherland.
Rothbarth
P H
PH
Brouwer
R M
RM
Wenting
G J
GJ
Jeekel
J
J
Weimar
W
W
D000914:Antibodies, Viral / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D016030:Kidney Transplantation; D008297:Male
D000914:Antibodies, Viral; D000961:Antilymphocyte Serum