title: Cytomegalovirus infection complicating renal transplantation and its relationship to acute transplant glomerulopathy.
abstract: The incidence of cytomegalovirus (CMV) infection was established, using laboratory criteria, in 298 patients receiving 362 renal allografts (164/298 = 55%). The incidence of CMV infection did not differ between azathioprine/prednisolone-treated and cyclosporine-treated patients (55% vs. 57% NS). The use of antithymocyte globulin (ATG) increased the incidence of CMV infection (78% vs. 51%: P less than 0.01). Donor and recipient CMV status, known for 116 allografts, did not correlate with the incidence of CMV infection (recipient CMV-positive = 50%; recipient CMV-negative = 54%: NS). CMV infection was responsible for 8 patients' deaths (2.7% mortality). Thirty-three patients with acute transplant glomerulopathy were identified (11%). There was no correlation between acute transplant glomerulopathy and CMV infection. Glomerulopathy was associated with poor graft survival (22/33 patients with a graft survival of less than 6 months). Thus CMV infection, although a common complication of renal transplantation with significant morbidity and mortality, is not closely associated with acute transplant glomerulopathy. Further, the lack of correlation of donor-recipient CMV serologic status with graft outcome limits the usefulness of pretransplantation donor screening.
authors.affiliation: Department of Nephrology, Prince Henry's Hospital, Melbourne, Australia.
authors.forename: N W
authors.initials: NW
authors.lastname: Boyce
authors.forename: K
authors.initials: K
authors.lastname: Hayes
authors.forename: D
authors.initials: D
authors.lastname: Gee
authors.forename: S R
authors.initials: SR
authors.lastname: Holdsworth
authors.forename: N M
authors.initials: NM
authors.lastname: Thomson
authors.forename: D
authors.initials: D
authors.lastname: Scott
authors.forename: R C
authors.initials: RC
authors.lastname: Atkins
mesh_terms: D000208:Acute Disease; D002455:Cell Division; D003524:Cyclosporins / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000209:etiology*; D004730:Endothelium, Vascular / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000098:blood supply / Q000473:pathology*; D016030:Kidney Transplantation; D014019:Tissue Donors
chemical_list: D003524:Cyclosporins