title: Donor and recipient CMV serostatus and antigenemia after renal transplantation: an analysis of 486 patients.
abstract: 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.
authors.affiliation: Nuffield Department of Surgery, John Radcliffe Hospital, Oxford OX3 9TU, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Hughes
authors.forename: John
authors.initials: J
authors.lastname: Hafferty
authors.forename: Lee
authors.initials: L
authors.lastname: Fulton
authors.forename: Peter
authors.initials: P
authors.lastname: Friend
authors.forename: Andrea
authors.initials: A
authors.lastname: Devaney
authors.forename: Justin
authors.initials: J
authors.lastname: Loke
authors.forename: Ken I
authors.initials: KI
authors.lastname: Welsh
authors.forename: Ashok
authors.initials: A
authors.lastname: Handa
authors.forename: Paul
authors.initials: P
authors.lastname: Klenerman
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa