Cytomegalovirus & Epstein Barr Virus serostatus as a predictor of the long-term outcome of kidney transplantation.
OBJECTIVE
Cytomegalovirus (CMV) and Epstein Barr Virus (EBV) disease and asymptomatic infection have been associated with poor outcomes in kidney transplantation. Recipients who acquire primary infection through transplantation from a seropositive donor may be at particular risk of complications. The primary aim of this study was to evaluate the relationship between donor/recipient (D/R) CMV and EBV serostatus pretransplant and allograft and patient survival in a large cohort of kidney transplant recipients.


METHODS
Data were obtained from the Australian and New Zealand Dialysis and Transplant Registry and the Australian and New Zealand Organ Donation Registry on 4516 first deceased donor kidney transplants performed between 1998 and 2010. Graft and patient survival were analysed using the Kaplan-Meier method.


RESULTS
Pretransplant CMV D/R serostatus was available for the whole cohort, with EBV D/R serostatus available for 2566 transplants (56.8%). Serostatus for both viruses was significantly associated with donor and recipient age and recipient smoking status. For both viruses the majority of transplants were in a D+/R+ serostatus setting: 45.3% for CMV and 77.9% for EBV. D/R serostatus for either virus did not have a significant effect on graft or patient survival.


CONCLUSIONS
We conclude that in the current era of viral prophylaxis and surveillance, long-term outcome for the kidney transplant population is unaffected by D/R CMV and EBV serostatus.
Department of Nephrology, Sydney Children's Hospital, Sydney, New South Wales, Australia; ANZDATA Registry, Adelaide, South Australia, Australia.
Amelia K
AK
Le Page
Fiona E
FE
Mackie
Steven J
SJ
McTaggart
Sean E
SE
Kennedy
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000914:Antibodies, Viral
Epstein Barr Virus infection; cytomegalovirus infection; graft failure; kidney transplantation; patient survival