Donor and recipient CMV serostatus and antigenemia after renal transplantation: an analysis of 486 patients.
BACKGROUND
Cytomegalovirus infection in renal transplant recipients is a major clinical problem, with both short and long term sequelae. Infection can occur as a result of reactivation of latent virus or new infection from donor tissues. The impact of donor and recipient serostatus on viremia is well recognised, with seronegative recipients at greatest risk after transplantation of an organ from a seropositive donor. However, the impact of grafting such organs into seropositive recipients is less clear.


OBJECTIVE
To assess the impact of recipient serostatus on the risk of CMV antigenemia in a large renal transplant cohort.


METHODS
We prospectively quantified CMV antigenemia over time in a cohort of 486 recipients. We analysed the antigenemia status according to donor and recipient serostatus.


RESULTS
Antigenemia was most common in seronegative recipients of organs from seropositive donors (D+/R-). Nevertheless, we observed that even in CMV seropositive recipients, the impact of donor serostatus on CMV antigenemia is still substantial (p=0.006; OR=2.2).


CONCLUSIONS
In this large study, donor serostatus clearly plays a significant role in determining CMV risk, even in seropositive recipients.
Hughes
David
D
Nuffield Department of Surgery, John Radcliffe Hospital, Oxford OX3 9TU, United Kingdom.
Hafferty
John
J
Fulton
Lee
L
Friend
Peter
P
Devaney
Andrea
A
Loke
Justin
J
Welsh
Ken I
KI
Handa
Ashok
A
Klenerman
Paul
P
D000914:Antibodies, Viral / Q000097:blood*; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010750:Phosphoproteins / Q000097:blood*; D014019:Tissue Donors; D014763:Viral Matrix Proteins / Q000097:blood*; D014775:Virus Activation
D000914:Antibodies, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa