2004
DOI: 10.1097/01.tp.0000122184.97674.20
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Pretransplant Recipient Cytomegalovirus Seropositivity and Hemodialysis Are Associated With Decreased Renal Allograft and Patient Survival

Abstract: Pretransplant CMV seropositivity is associated with decreased patient survival. Pretransplant CMV seropositivity and hemodialysis have a synergistic adverse effect on graft survival, independent of patient mortality. Additional studies are required to define mechanisms by which pretransplant CMV infection and dialysis modality may contribute to decreased allograft survival.

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Cited by 20 publications
(13 citation statements)
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“…Epstein-Barr virus-associated posttransplant lymphoproliferative disease occurs in up to 20% of graft recipients, depending on the type of allograft (93). Chemical prophylaxis has reduced the incidence and severity of CMV infection, but it is still associated with both acute and chronic rejection (94), and other morbidities and mortality (95,96). New experimental DC-based therapies have been used to target these viruses.…”
Section: Dendritic Cells and The Prevention And Treatment Of Transplamentioning
confidence: 98%
“…Epstein-Barr virus-associated posttransplant lymphoproliferative disease occurs in up to 20% of graft recipients, depending on the type of allograft (93). Chemical prophylaxis has reduced the incidence and severity of CMV infection, but it is still associated with both acute and chronic rejection (94), and other morbidities and mortality (95,96). New experimental DC-based therapies have been used to target these viruses.…”
Section: Dendritic Cells and The Prevention And Treatment Of Transplamentioning
confidence: 98%
“…A higher incidence of viral DNA in the explant vascular intima from patients with cardiac allograft TVS than in explants without vasculopathy further underscores the influence of HCMV on CR development (47). In kidney transplant patients, the presence of HCMV infection, whether asymptomatic or displaying overt symptoms, negatively impacts allograft survival (9). The role of HCMV in TVS/CR development is clear; however, the mechanisms involved in this process remain illusive for the following reasons: HCMV disease etiology is multifactorial; HCMV is ubiquitous throughout the human population; HCMV infection is lifelong and infects all of the cell types involved in TVS, including smooth muscle cells (SMC), endothelial cells (EC), and macrophages; and HCMV evades the immune system by remaining latent, and clinically silent reactivation is difficult to detect (3,18,19,28,30).…”
mentioning
confidence: 99%
“…Additional proof to HCMV's affect on graft TVS comes from the finding of a higher incidence of viral DNA detected in the explant vascular intima of those patients with cardiac allograft TVS than in those explants without vasculopathy (Wu et al 1992). In fact, the mere presence of HCMV infection in kidney transplant patients, whether displaying asymptomatic or overt symptoms, was shown to negatively impact allograft survival (Fitzgerald et al 2004). While a number of studies have provided strong evidence for a role of HCMV in the development of TVS and accelerated CR, the precise mechanisms involved in this process are still unknown.…”
mentioning
confidence: 99%