Simultaneous Pancreas/Kidney Transplant Recipients Are Predisposed to Symptomatic CMV-Infection and Concomitant Infectious Complications.
1Nephrology and Internal Intensive Care, Charite Campus Virchow Clinic, Berlin, Germany
2Berlin-Brandenburg Center for Regenerative Therapies, Charite Campus Virchow Clinic, Berlin, Germany
3Berlin Institute of Health BIH, Berlin, Germany
Meeting: 2017 American Transplant Congress
Abstract number: C234
Keywords: Cytomeglovirus, Epstein-Barr virus (EBV), Kidney/pancreas transplantation, Outcome
Session Information
Session Name: Poster Session C: Pancreas and Islet (Auto and Allo) Transplantation
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Infections have increased in simultaneous pancreas/kidney transplant recipients (SPKTRs) with CMV-infection being the most important viral infection with adverse impact on patient and allograft outcomes. A comparison of CMV-infection between SPKTRs and kidney transplant recipients (KTRs), and the association of CMV-infection with other infectious complications in SPKTRs, however, remains scarcely described.
Here, we studied all primary SPKTRs and primary deceased-donor KTRs (<65 years) at our transplant center between 2008 and 2015 for the development of active CMV-infection. 21 of 62 SPKTRs (33.9%) and 90 of 335 KTRs (26.9%) were diagnosed with CMV viremia. A control group of 41 SPKTRs without CMV viremia was used for comparison.
SPKTRs showed an increased incidence of active CMV-infection compared to KTRs. SPKTRs were more likely to develop CMV-disease, CMV pneumonia, recurrent CMV-infection, higher initial and peak CMV-loads, and more need for intravenous antiviral therapy compared to KTRs (p<0.05). High-risk CMV-serostatus (D+R-) and 2 HLA-B/-DR mismatches increased the risk of CMV-infection in SPKTRs (p<0.05). No differences were observed for patient and allograft outcomes (p>0.05). SPKTRs with CMV-infection were more likely to show concomitant EBV viremia compared to SPKTRs without CMV-infection (p<0.05). SPKTRs with CMV-infection showed higher incidences of concomitant BK viremia, EBV viremia, and septic complications compared to KTRs with active CMV-infection (p<0.05).
Our results suggest a higher incidence and more severe course of active CMV-infection in SPKTRs compared to KTRs. The increased incidence of concomitant infectious complications among SPKTRs with CMV-infection suggests an overall impaired immunity, and calls for more intense screening.
CITATION INFORMATION: Schachtner T, Zaks M, Kahl A, Reinke P. Simultaneous Pancreas/Kidney Transplant Recipients Are Predisposed to Symptomatic CMV-Infection and Concomitant Infectious Complications. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Schachtner T, Zaks M, Kahl A, Reinke P. Simultaneous Pancreas/Kidney Transplant Recipients Are Predisposed to Symptomatic CMV-Infection and Concomitant Infectious Complications. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/simultaneous-pancreaskidney-transplant-recipients-are-predisposed-to-symptomatic-cmv-infection-and-concomitant-infectious-complications/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress