Long-term CMV monitoring and chronic rejection in renal transplant recipients

被引:4
作者
Ishikawa, Shoko [1 ]
Tasaki, Masayuki [1 ]
Saito, Kazuhide [1 ]
Nakagawa, Yuki [1 ,2 ]
Ikeda, Masahiro [1 ]
Takahashi, Kota [3 ]
Tomita, Yoshihiko [1 ]
机构
[1] Niigata Univ, Grad Sch Med & Dent Sci, Dept Regenerat & Transplant Med, Div Urol, Niigata, Japan
[2] Juntendo Univ, Grad Sch Med, Dept Urol, Tokyo, Japan
[3] Takahashi Mem Med Inst, Tokyo, Japan
来源
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY | 2023年 / 13卷
关键词
kidney transplantation; chronic rejection; CMV; monitoring; long-term; CELL IMMUNE RECONSTITUTION; CYTOMEGALOVIRUS-INFECTION; PROPHYLAXIS; DISEASE; RISK; VALGANCICLOVIR; MULTICENTER; IMPACT; PCR;
D O I
10.3389/fcimb.2023.1190794
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
IntroductionCytomegalovirus (CMV) is well established to be an independent risk factor for graft loss after kidney transplantation (KTx). Monitoring for CMV in the chronic phase is not defined in the current guideline. The effects of CMV infection, including asymptomatic CMV viremia, in the chronic phase are unclear. MethodsWe performed a single-center retrospective study to investigate incidence of CMV infection in the chronic phase, defined as more than 1 year after KTx. We included 205 patients who received KTx between April 2004 and December 2017. The CMV pp65 antigenemia assays to detect CMV viremia were continuously performed every 1-3 months. ResultsThe median duration of the follow-up was 80.6 (13.1-172.1) months. Asymptomatic CMV infection and CMV disease were observed in 30.7% and 2.9% in the chronic phase, respectively. We found that 10-20% of patients had CMV infections in each year after KTx which did not change over 10 years. The history of CMV infection in the early phase (within 1 year after KTx) and chronic rejection were significantly associated with CMV viremia in the chronic phase. CMV viremia in the chronic phase was significantly associated with graft loss. DiscussionThis is the first study to examine the incidence of CMV viremia for 10 years post KTx. Preventing latent CMV infection may decrease chronic rejection and graft loss after KTx.
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页数:11
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