title: A prospective study of the predictive value of polymerase chain reaction assay for cytomegalovirus in asymptomatic kidney transplant recipients.
abstract: Cytomegalovirus (CMV) infection carries the potential for high morbidity in transplant recipients. The institution of pre-emptive therapy prior to the onset of clinical disease on the basis of CMV-polymerase chain reaction (PCR) is very attractive. We prospectively studied 52 asymptomatic kidney transplant recipients to test the hypothesis that serial CMV-PCR assays during the first 3 months post-transplant would identify patients at risk for CMV disease. Twenty-three patients (44.2%) had positive CMV-PCR tests at least once; 2 (8.6%) developed CMV. None of the 29 patients continuously negative for CMV-PCR developed CMV disease. CMV-PCR status did not influence patient and graft survival or the incidence of acute rejection. We conclude that while a substantial number of kidney transplant recipients become positive for CMV-PCR in the early post-transplant period, only a minority will develop CMV disease. Negative CMV-PCR assay is an accurate negative predictor for CMV disease but the value of CMV-PCR as a guide for pre-emptive anti-CMV therapy in kidney transplant recipients appears limited.
authors.affiliation: Department of Surgery, University of Illinois at Chicago 60612, USA.
authors.forename: E
authors.initials: E
authors.lastname: Benedetti
authors.forename: M
authors.initials: M
authors.lastname: Mihalov
authors.forename: M
authors.initials: M
authors.lastname: Asolati
authors.forename: J
authors.initials: J
authors.lastname: Kirby
authors.forename: T
authors.initials: T
authors.lastname: Dunn
authors.forename: V
authors.initials: V
authors.lastname: Raofi
authors.forename: M
authors.initials: M
authors.lastname: Fontaine
authors.forename: R
authors.initials: R
authors.lastname: Pollak
mesh_terms: D000328:Adult; D000368:Aged; D003587:Cytomegalovirus / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D004279:DNA, Viral