title: The effect of cytomegalovirus antigenemia titer on the efficacy of preemptive therapy for the prevention of cytomegalovirus disease after kidney transplantation.
abstract: There is some controversy regarding the exact cytomegalovirus (CMV) antigenemia titer that should be used as a guideline for preemptive anti-CMV therapy. We performed 634 consecutive kidney transplantations between January 2000 and June 2007. Preemptive therapy employed intravenous gancyclovir treatment when the CMV antigenemia titer was >or=50/4x10(5) leukocytes after kidney transplantation. The 634 recipients were allocated into 2 groups according to the peak CMV antegenemia: group A, CMV antigenemia titer<50/4x10(5) (n=550); and group B, >or=50/40x10(5) (n=84). Among the 634 recipients, 264 were positive for CMV antigenemia, and 61 developed symptomatic CMV infections. The incidence of symptomatic CMV infections in group B was significantly higher than in group A. Two cases in both groups developed tissue-proven CMV disease: group A CMV colitis and CMV nephritis, and group B, 2 cases of CMV colitis. Graft and patient survival rates in groups A and B at 5 years posttransplantation were not different. The authors concluded that a CMV antigenemia titer of >or=50/4x10(5) leukocytes can be considered an appropriate guideline for preemptive anti-CMV therapy.
authors.affiliation: Department of Surgery, Division of Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: G O
authors.initials: GO
authors.lastname: Jung
authors.forename: S-J
authors.initials: SJ
authors.lastname: Kim
authors.forename: G-S
authors.initials: GS
authors.lastname: Choi
authors.forename: J I
authors.initials: JI
authors.lastname: Moon
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.forename: M J
authors.initials: MJ
authors.lastname: Sin
authors.forename: E Y
authors.initials: EY
authors.lastname: Kim
authors.forename: C H D
authors.initials: CH
authors.lastname: Kwon
authors.forename: J W
authors.initials: JW
authors.lastname: Joh
authors.forename: S-K
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002102:Cadaver; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000956:Antigens, Viral; D000998:Antiviral Agents; D007166:Immunosuppressive Agents