Cytomegalovirus Viremia after Living and Deceased Donation in Kidney Transplantation

Jehn, U.; Schütte‐Nütgen, Katharina; Bautz, Joachim; Pavenstädt, Hermann; Suwelack, Barbara; Thölking, Gerold; Heinzow, Hauke; Reuter, Stefan

doi:10.3390/jcm9010252

Cited by 11 publications

(21 citation statements)

References 36 publications

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“…Interestingly, patients who developed CMV DNAemia within the first year after KTx had higher GDF15 levels after one year, but were also characterized by inferior allograft function. This is in line with CMV data from a larger cohort than our center [17]. However, after adjustment for eGFR, the association did not remain significant.…”

Section: Discussionsupporting

confidence: 90%

“…Proteinuria was assessed using spot urine. CMV-DNAemia was assessed as published previously [17]. In short, viremia was considered relevant if >214.6 copies/mL corresponding to the threshold value given by the manufacturer (90% CI 163 to 355 IU/mL, kPCR PLX®CMV DNA-Assay in combination with the VERSANT®kPCR molecular system, Siemens Healthcare Diagnostics, Eschborn, Germany) was documented.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Since CMV-DNAemia, proteinuria and rejection show a strong association with renal function [17], we adjusted these factors for the 1-year eGFR. After adjustment, CMV-DNAemia (p = 0.163), rejection episodes (p = 0.245) and proteinuria after one year (p = 0.968) did not show any association to GDF15.…”

Section: Adjustmentmentioning

confidence: 99%

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Prognostic Value of Growth Differentiation Factor 15 in Kidney Donors and Recipients

Jehn

Schütte‐Nütgen

Henke

et al. 2020

JCM

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Growth differentiation factor-15 (GDF15) is associated with inflammatory conditions, chronic kidney disease, cardiovascular disease and mortality. There is very limited data on GDF15 after kidney donation and transplantation. We analyzed serum samples of patients who donated a kidney (54 living donors) or who underwent kidney transplantation (104 recipients) at the University Hospital of Münster (Germany) between 2013 and 2015, for GDF15 levels immediately prior and one year after surgery. GDF15 levels were significantly elevated in end-stage renal disease patients compared to healthy individuals (2844 (IQR 2087, 3361) pg/ml vs. 384 (IQR 307, 487) pg/ml, p < 0.001). GDF15 was strongly associated with the dialysis vintage. While kidney transplantation led to a significant decrease of GDF15 (913 (IQR 674, 1453) pg/ml, p < 0.001), kidney donation caused a moderate increase of GDF15 (510 (IQR 420, 626), p < 0.001) one year after surgery. GDF15 levels remained significantly higher in recipients and kidney donors than in healthy controls (735 (IQR 536, 1202) pg/ml vs. 384 (IQR 307, 487) pg/ml, p < 0.001). GDF15 is increased in patients with kidney disease and is associated with dialysis vintage. Given its decrease after transplantation and its increase after uni-nephrectomy, GDF15 might be a marker of kidney function. However, since it correlates only to the eGFR in transplanted patients it may indicate chronic kidney disease.

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Section: Discussionsupporting

confidence: 90%

Section: Outcome Measuresmentioning

confidence: 99%

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Prognostic Value of Growth Differentiation Factor 15 in Kidney Donors and Recipients

Jehn

Schütte‐Nütgen

Henke

et al. 2020

JCM

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“…A CMV-positive donor, rejection episodes and deceased donor transplantation depict major risk factors for CMV infection in KTx patients 5 . The main risk factors for BKPyV infection are transplantation of grafts from BKPyV-seropositive donors into BKPyV-seronegative recipients, the number of HLA mismatches, ischemic injury, and prior acute rejection 6 .…”

Section: Introductionmentioning

confidence: 99%

Clinical features of BK-polyomavirus and cytomegalovirus co-infection after kidney transplantation

Jehn

Schütte‐Nütgen

Bautz

et al. 2020

Sci Rep

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BK polyomavirus (BKPyV) and cytomegalovirus (CMV) are the main viral pathogens affecting the graft and recipient outcome after allogenic kidney transplantation. It has recently been found that infection with both viruses has a greater impact on kidney graft function than a single infection. We retrospectively analyzed a cohort of 723 recipients who received kidney transplantation between 2007 and 2015 after living and postmortal donation for differences in risk and outcome parameters regarding BKPyV (DNAemia) and CMV (CMV DNAemia) co-infection compared to sole viremias and to patients without viremia. Of all kidney allograft recipients in our cohort, 8.2% developed co-infection with BKPyV DNAemia and CMV DNAemia, 15.1% showed BKPyV viremia alone and 25.2% sole CMV DNAemia. Acute rejection was closely linked with co-infection (multivariable analysis, p = 0.001). Despite the fact that the estimated glomerular filtration rate of patients with co-infection was noticeably reduced compared to patients with BKV or CMV infection alone, transplant survival and patient survival were not significantly reduced. Co-infection with BKPyV and CMV in kidney transplanted patients is significantly associated with inferior allograft function. Since co-infection is strongly associated with acute rejection, co-infected individuals should be considered a risk collective.

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“…Donor status has been a well-known important factor for short-and long-term mortality after kidney transplantation [15,45]. According to previous studies, kidney allograft recipients that died within the first year after transplantation were more likely to be recipients of deceased donor kidneys [18,44].…”

Section: Plos Onementioning

confidence: 99%

The risk factors associated with treatment-related mortality in 16,073 kidney transplantation—A nationwide cohort study

et al. 2020

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Mortality at an early stage after kidney transplantation is a catastrophic event. Treatmentrelated mortality (TRM) within 1 or 3 months after kidney transplantation has been seldom reported. We designed a retrospective observational cohort study using a national population-based database, which included information about all kidney recipients between 2003 and 2016. A total of 16,073 patients who underwent kidney transplantation were included. The mortality rates 1 month (early TRM) and 3 months (TRM) after transplantation were 0.5% (n = 74) and 1.0% (n = 160), respectively. Based on a multivariate analysis, older age (hazard ratio [HR] = 1.06; P < 0.001), coronary artery disease (HR = 3.02; P = 0.002), and hemodialysis compared with pre-emptive kidney transplantation (HR = 2.53; P = 0.046) were the risk factors for early TRM. Older age (HR = 1.07; P < 0.001), coronary artery disease (HR = 2.88; P < 0.001), and hemodialysis (HR = 2.35; P = 0.004) were the common independent risk factors for TRM. In contrast, cardiac arrhythmia (HR = 1.98; P = 0.027) was associated only with early TRM, and fungal infection (HR = 2.61; P < 0.001), and epoch of transplantation (HR = 0.34; P < 0.001) were the factors associated with only TRM. The identified risk factors should be considered in patient counselling, selection, and management to prevent TRM.

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Cytomegalovirus Viremia after Living and Deceased Donation in Kidney Transplantation

Cited by 11 publications

References 36 publications

Prognostic Value of Growth Differentiation Factor 15 in Kidney Donors and Recipients

Prognostic Value of Growth Differentiation Factor 15 in Kidney Donors and Recipients

Clinical features of BK-polyomavirus and cytomegalovirus co-infection after kidney transplantation

The risk factors associated with treatment-related mortality in 16,073 kidney transplantation—A nationwide cohort study

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