title: Late-acute renal allograft rejection and symptomless cytomegalovirus infection.
abstract: The role of cytomegalovirus infection in allograft injury is controversial. A subgroup of renal graft recipients who had histologically proven late-acute rejection did not respond to conventional anti-rejection therapy (80% graft loss within 1 year). These patients showed an expansion of memory-type CD8 peripheral-blood T cells that expressed interferon-gamma mRNA and an association with clinically symptomless cytomegalovirus infection (82% PCR positive, 42% antigenaemia). Antiviral therapy with ganciclovir resulted in stable improved graft function in 17 of 21 treated patients with cytomegalovirus-associated late-acute rejection. The results underline the clinical relevance of cytomegalovirus-related graft injury and offer a novel therapeutic approach.
authors.affiliation: Medical Clinic V-Nephrology, Universitätsklinikum Charité, Berlin, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Reinke
authors.forename: E
authors.initials: E
authors.lastname: Fietze
authors.forename: S
authors.initials: S
authors.lastname: Ode-Hakim
authors.forename: S
authors.initials: S
authors.lastname: Prösch
authors.forename: J
authors.initials: J
authors.lastname: Lippert
authors.forename: R
authors.initials: R
authors.lastname: Ewert
authors.forename: H D
authors.initials: HD
authors.lastname: Volk
mesh_terms: D000208:Acute Disease; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007156:Immunologic Memory; D016030:Kidney Transplantation; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D013601:T-Lymphocytes; D013997:Time Factors