The association of viral infection and chronic allograft nephropathy with graft dysfunction after renal transplantation.
BACKGROUND
The long-term effect of viral infections on graft dysfunction and rejection after renal transplantation is uncertain.


METHODS
A cohort of 37 renal transplant recipients was followed prospectively for 3 years. Creatinine clearance rate at 6 months and 3 years and chronic allograft nephropathy were correlated with the detection of cytomegalovirus (CMV), human herpesvirus 6 and human herpesvirus 7 and BK virus DNA, CMV disease, and acute rejection.


RESULTS
CMV disease was significantly associated with poor graft function at 6 months, whereas chronic allograft nephropathy was associated with graft dysfunction at 3 years. Both CMV disease and detection of human herpesvirus 6 DNA were associated with chronic allograft nephropathy.


CONCLUSIONS
CMV disease was a significant cause of early graft dysfunction, whereas the presence of chronic allograft nephropathy was the main determinant of poor long-term graft function. The role of viral infections in chronic allograft nephropathy deserves further investigation.
D001739:BK Virus / Q000302:isolation & purification; D002908:Chronic Disease; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000503:physiopathology*; D004279:DNA, Viral / Q000032:analysis; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D014184:Transplantation, Homologous
D004279:DNA, Viral