Cytomegalovirus infection and graft rejection in renal transplantation: a single-center experience

Lee, W; Tsang, Wing Pui; Tong, K.L; Chan, HW

doi:10.1016/s0041-1345(02)03908-8

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…It is well known that AR is a time-dependent negative prognostic factor to graft survival and long-term function (7,8,17,18), but its association with CMV disease when both affect the transplant recipient is not well established (3,14,15,19). In the present study with 2,740 kidney and simultaneous pancreas-kidney transplant recipients we found that both CMV disease and AR are independent risk factors for graft loss.…”

Section: Discussionsupporting

confidence: 41%

“…Although there are some indications that CMV disease is associated with increased risk for AR (3, 10 -12), other reports failed to show this correlation (13)(14)(15). When AR and CMV both occur in kidney transplant recipients, AR usually precedes CMV disease (14,16) suggesting that an AR episode can trigger a CMV infection possibly due secondary to immunosuppressive therapy.…”

mentioning

confidence: 99%

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Association of Cytomegalovirus Disease and Acute Rejection with Graft Loss in Kidney Transplantation

Nett¹,

Heisey²,

Fernández³

et al. 2004

Transplantation

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Section: Discussionsupporting

confidence: 41%

mentioning

confidence: 99%

Association of Cytomegalovirus Disease and Acute Rejection with Graft Loss in Kidney Transplantation

Nett¹,

Heisey²,

Fernández³

et al. 2004

Transplantation

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“…Several investigators have reported that more acute rejection episodes occur in patients with CMV infection [7][8][9], but this association remains controversial [11][12][13]. Notwithstanding the possible accumulation of ARE in patients with CMV, it also remains to be clarified whether CMV infection precedes ARE or vice versa.…”

Section: Association Of CMV Infection With Acute Cellular Rejection Omentioning

confidence: 99%

“…Reduced graft survival could be related to an increased rate of acute rejections (ARs) in patients with CMV as suggested by experimental [5,6] and clinical studies [7][8][9][10]. However, the association between CMV and AR remains controversial since some investigators could not confirm this finding [11][12][13]. Also, it is uncertain whether CMV infection promotes AR [5] or if augmented immunosuppressive therapy in the setting of AR causes CMV infection [12,14].…”

Section: Introductionmentioning

confidence: 99%

Impact of CMV infection on acute rejection and long-term renal allograft function: a systematic analysis in patients with protocol biopsies and indicated biopsies

Erdbruegger

Scheffner

Mengel

et al. 2011

Nephrology Dialysis Transplantation

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“…It has been proposed that CMV can lead to an increase in rejection, which could in turn explain the increased risk for graft loss and mortality. However, this hypothesis remains controversial as numerous studies have been unable to support this finding …”

Section: Introductionmentioning

confidence: 97%

The risk of cytomegalovirus infection after treatment of acute rejection in renal transplant recipients

Jorgenson

Descourouez

Lyu

et al. 2019

Clinical Transplantation

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The risk of cytomegalovirus infection (CMV) after rejection treatment is poorly understood. To investigate this, we conducted a case/control (1:2) analysis of adult renal transplant recipients between January 1, 2005 and December 31, 2015, via incidence density sampling and survival analysis. Our objective was to evaluate the association of prior acute rejection with subsequent CMV, including epidemiology and outcomes. There were 2481 eligible renal transplants within the study period and 251 distinct CMV infections. Despite the use of antiviral prophylaxis rejection was a significant risk factor for CMV on unadjusted (HR 1.73 [1.34, 2.24] P < 0.05) and adjusted analysis (HR 1.46 [1.06, 2.04] P < 0.05). When matching cases to controls patients with CMV had significantly more rejection prior to CMV diagnosis (26.7% vs 14.2%, P < 0.01). CMV was associated with a twofold increased risk of prior rejection on unadjusted (OR 1.94, 95%CI: 1.28‐2.96, P < 0.01) and adjusted analysis (OR 2.16, 95% CI: 1.31‐3.58, P < 0.01). Patients with rejection preceding CMV had significantly increased graft loss (HR 2.89, 95% CI: 1.65‐5.09, P < 0.01) and mortality (HR 1.82, 95% CI: 1.12‐4.24, P = 0.03) as compared to those CMV cases without rejection. In conclusion, rejection is a risk factor for CMV infection that appears to persist for 1 year. Preceding rejection events increased risk of graft loss and mortality in CMV patients. Given this, prolonged surveillance monitoring for CMV after rejection may be warranted. Studies are needed investigating optimal monitoring strategies.

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Cytomegalovirus infection and graft rejection in renal transplantation: a single-center experience

Cited by 6 publications

References 6 publications

Association of Cytomegalovirus Disease and Acute Rejection with Graft Loss in Kidney Transplantation

Association of Cytomegalovirus Disease and Acute Rejection with Graft Loss in Kidney Transplantation

Impact of CMV infection on acute rejection and long-term renal allograft function: a systematic analysis in patients with protocol biopsies and indicated biopsies

The risk of cytomegalovirus infection after treatment of acute rejection in renal transplant recipients

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