[Cytomegalovirus infection in kidney transplant recipients in Santariskes Clinics of Vilnius University Hospital].
Between January 2000 and December 2006, 318 kidney transplants were performed in our unit. Cytomegalovirus infection in transplanted patients causes both direct and indirect effects on other organ systems, including acute allograft rejection and decreased graft and patient survival. The aim of our study was to evaluate the incidence of cytomegalovirus infection after kidney transplantation, the treatment strategies, and the impact of cytomegalovirus infection on allograft function and survival. Those patients who at least once were treated for cytomegalovirus infection were assigned to the study group (n=102). The control group included the remaining patients (n=216) in whom kidney transplantation was performed between January 2000 and December 2006. The mean age of the recipients in both groups was 39.8+/-12.8 years (range 15-60) and 38.5+/-12.6 years (range 7-66), respectively; retransplantations and acute allograft rejections were more common in the group treated for cytomegalovirus infection: 13 (12.7%) vs. 18 (8.3%) and 55 (53.9%) vs. 103 (47.2%), respectively. Between January 2000 and December 2006, the total number of cytomegalovirus infection episodes was 167. The greatest number of cytomegalovirus infection episodes occurred during the first 1-3 months after transplantation and accounted for 27.5%; during 3-6 months, 17.4%; during 6-12 months, 18.6%. Serum creatinine levels were higher in our study group. Cytomegalovirus infection manifested as pneumonitis in 26.5% and as gastrointestinal tract disorders in 9.8% of cases; 3.9% of patients were treated for encephalitis. Patients in the study group reported more frequently other infections: bacterial infections, 66 (64.7%) vs. 116 (53.7%); virus infections, 2 (2%) vs. 3 (1.4%); and mixed bacterial-virus infections, 8 (7.8%) vs. 4 (1.9%). The number of patients who did not experience any infection was higher in control group: 26 (25.5%) vs. 93 (43.1%). Death from cytomegalovirus infection occurred in 15 (14.7%) of the 102 patients in the study group.
Asakiene
Egle
E
Unit of Dialysis and Kidney Transplantation, Center of Nephrology, Santariskes Clinics of Vilnius University Hospital, Vilnius, Lithuania. egle.asakiene@santa.lt
Alekniene
Dalia
D
Supranaviciene
Lilija
L
Miglinas
Marius
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003404:Creatinine / Q000097:blood; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D003937:Diagnosis, Differential; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection; D006085:Graft Survival; D006785:Hospitals, University; D006801:Humans; D016030:Kidney Transplantation; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014019:Tissue Donors
D000998:Antiviral Agents; D003404:Creatinine; D015774:Ganciclovir