Kidney Allocation Using CMV Matching Optimizes Low and High Risk Profiles for Prevention of CMV Infection in Kidney Transplant Recipients.

J. Lockridge,¹ E. Langewisch,² D. Basuli,¹ A. Olyaei,³ C. Shaut,⁴ D. Norman.¹

¹Division of Nephrology, Department of Medicine, Oregon Health and Science University, Portland, OR
²Nephrology, University of Nebraska, Omaha, NE
³Pharmacy, Oregon Health and Sciences University, Portland, OR
⁴Immunogenetics and Transplant, Oregon Health and Sciences University, Portland, OR

Meeting: 2017 American Transplant Congress

Abstract number: A192

Keywords: Cytomeglovirus, Prophylaxis, Viral therapy, Waiting lists

Session Information

Session Name: Poster Session A: Kidney Complications I

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Cytomegalovirus (CMV) confers a major impact on morbidity, mortality, and graft survival in kidney transplant recipients. Efforts to prevent CMV disease and infection have traditionally focused on post transplant prophylaxis and preemptive antiviral therapy. We propose a novel pre transplant CMV prevention strategy via matching deceased kidney donors and recipients by CMV serostatus. The aim of CMV matching is to reduce the number of high risk donor seropositive / recipient seronegative (D+/R-) transplants and increase the number of low risk donor negative / recipient negative (D-/R-) transplants without adversely affecting wait times for a deceased donor kidney. In this retrospective multicenter study of 622 (314 pre CMV matching; 308 post CMV matching) deceased donor kidney transplant recipients, the CMV matching intervention decreased the number of high risk (D+/R-) transplants from 60 (19.1%) to 9 (2.9%) (p<0.0001) and increased the number of low risk (D-/R-) transplants from 42 (13.4%) to 74 (24%) (p=0.0007). Before and after intervention, median days on the wait list changed from 651 to 853. Median days on the wait list changed from 696 to 862 for CMV negative recipients and from 611 to 843 for CMV positive recipients. While our centers continue to allocate kidneys according to CMV matching, this study included only patients transplanted before 12/4/2014 when the new allocation program was implemented by UNOS. Not surprisingly, median waiting times for a kidney transplant increased for all patients during this study due to growing waiting list size, but neither CMV negative nor CMV positive patients appeared to be disadvantaged by implementing CMV matching. CMV matching optimizes high and low risk CMV profiles and has the potential to significantly improve CMV related morbidity and mortality, promote graft survival, and reduce costs associated with treatment.

CITATION INFORMATION: Lockridge J, Langewisch E, Basuli D, Olyaei A, Shaut C, Norman D. Kidney Allocation Using CMV Matching Optimizes Low and High Risk Profiles for Prevention of CMV Infection in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Lockridge J, Langewisch E, Basuli D, Olyaei A, Shaut C, Norman D. Kidney Allocation Using CMV Matching Optimizes Low and High Risk Profiles for Prevention of CMV Infection in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-allocation-using-cmv-matching-optimizes-low-and-high-risk-profiles-for-prevention-of-cmv-infection-in-kidney-transplant-recipients/. Accessed November 22, 2024.

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