title: The influence of cytomegalovirus infections on patient and renal graft outcome: a 3-year, multicenter, observational study (Post-ECTAZ Study).
abstract: Cytomegalovirus (CMV) infections posttransplant may increase the risk of acute rejection, graft failure, patient death, opportunistic infections, malignancy, diabetes, and cardiovascular complications. ECTAZ, a multicenter, randomized trial compared safety and efficacy at 12 months (M12) of two doses daclizumab (54 patients, group D) with thymoglobulin (55 patients, group T), plus cyclosporine (CsA), mycophenolate mofetil and steroids in first cadaveric kidney transplant patients. D+/R- patients received oral ganciclovir prophylaxis for 90 days. Post-ECTAZ is a 36-month, multicenter, observational study including recipients who participated in ECTAZ trial. We studied the indirect effects of CMV infections, whether recipients experienced (CMVi+) or not (CMVi-) a CMV infection/syndrome/disease. We compared 49 patients in the group CMVi+ with 54 patients in the group CMVi-. At month 36 (M36), patient survival, graft survival and renal function were comparable. The incidence of biopsy-proven acute rejection was 16.3% in the CMVi+ group versus 24.1% in the CMVi- group (not significant). The incidence of infections was increased in the CMVi+ group (P = .004), but not diabetes, malignancies, and cardiovascular complications. Our study shows at M36 that CMV infection/syndrome/disease episodes were associated with a higher incidence of infections but no difference for other long-term complications. Our data suggest that anti-CMV prophylaxis could decrease the risk for long-term related CMV complications.
authors.affiliation: Department of Nephrology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France. r.abou-ayache@chu-poitiers.fr
authors.forename: R
authors.initials: R
authors.lastname: Abou-Ayache
authors.forename: M
authors.initials: M
authors.lastname: Büchler
authors.forename: P
authors.initials: P
authors.lastname: Le Pogamp
authors.forename: P-F
authors.initials: PF
authors.lastname: Westeel
authors.forename: Y
authors.initials: Y
authors.lastname: Le Meur
authors.forename: I
authors.initials: I
authors.lastname: Etienne
authors.forename: B
authors.initials: B
authors.lastname: Hurault de Ligny
authors.forename: O
authors.initials: O
authors.lastname: Toupance
authors.forename: S
authors.initials: S
authors.lastname: Caillard
authors.forename: G
authors.initials: G
authors.lastname: Sinnasse-Raymond
authors.forename: G
authors.initials: G
authors.lastname: Touchard
mesh_terms: D000284:Administration, Oral; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000503:physiopathology* / Q000517:prevention & control; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir