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CMV Infection in Renal Transplant Recipients: Incidence and Efficacy of Prophylaxis According to Cytokine Single Nucleotide Polymorphisms.

I. Perez-Flores, M. Moreno De La Higuera, N. Calvo Romero, B. Rodriguez Cubillo, A. Shabaka, M. Calvo Arevalo, V. Lopez De La Manzanara, A. Sanchez-Fructuoso.

Nephrology, Hospital Clínico San Carlos, Madrid, Spain

Meeting: 2017 American Transplant Congress

Abstract number: A275

Keywords: Cytomeglovirus, Polymorphism

Session Information

Session Name: Poster Session A: Viral Conundrums

Session Type: Poster Session

Date: Saturday, April 29, 2017

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

 Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Objectives: To evaluate the influence of single nucleotide polymorphisms (SNP)of IL10, TNFα, IFNγand IL18 in the incidence of CMV infection in renal transplant recipients. Methods: A retrospective cohort study from a prospective database included 709 patients that received a renal transplant at our center between 2005-2013. We excluded re-transplant, not Caucasian, primary graft failure or death in the early post-transplant. SNP analysis was performed by real-time PCR with Taqman® probes. The patients were stratified according to the higher producing genotype. Results: The incidence of CMV infection and disease was of 37% and 6.4% respectively.The main risk factors are described in tables 1 and 2. There was a significant independent association between SNP -137 G/C of IL18 and CMV infection, where carriers of G allele had a higher risk of CMV infection (OR=2.79; CI 95%: 1.00-7.78; p=0.044). In the subgroup of patients that received prophylaxis for CMV, the main risk factor for infection after discontinuation of Valgancyclovir was being a carrier of G allele (OR=5.10; CI 95%: 1.12-23.20; p=0.035). No patients developed CMV disease within non-carriers.

CMV INFECTION (REGRESSION MODEL) OR (CI 95%) P
IL18-137
GG/GC VS CC 2.79 (1.01-7.78) 0.044
ACUTE VASCULAR REJECTION
YES VS NO 2.63 (1.55-4.45) <0.01
RECIPIENT AGE
>60 YEARS VS <60 YEARS 1.73 (1.11-2.69) 0.014
COLD ISCHEMIA TIME
>18H VS < 18H 1.64 (1.07-2.50) 0.022
DELAYED GRAFT FUNCTION
YES VS NO 1.63 (1.06-2.51) 0.026

CMV DISEASE OR (CI 95%) P
ACUTE VASCULAR REJECTION(YES VS NO) 6.83(3.01-15.59) <0.01
RECIPIENT GENDER 3.41(1.50-7.75) 0.003
CMVIgG (D+/R-) VS (D-/R+ & D+/R+) 3.74(1.54-9.08) 0.003

Conclusions: SNP -137G/C of IL18 can affect the incidence of CMV infection and response towards prophylaxis with Valgancyclovir. The knowledge of these polymorphisms in recipients previous to transplantation and a closer virologicalmonitorization in those patients with a higher risk of CMV infection can aid in the individualization of treatment regimens and lower the rate of infectious complications.

CITATION INFORMATION: Perez-Flores I, Moreno De La Higuera M, Calvo Romero N, Rodriguez Cubillo B, Shabaka A, Calvo Arevalo M, Lopez De La Manzanara V, Sanchez-Fructuoso A. CMV Infection in Renal Transplant Recipients: Incidence and Efficacy of Prophylaxis According to Cytokine Single Nucleotide Polymorphisms. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Perez-Flores I, Romero NCalvo, Cubillo BRodriguez, Shabaka A, Arevalo MCalvo, Sanchez-Fructuoso A. CMV Infection in Renal Transplant Recipients: Incidence and Efficacy of Prophylaxis According to Cytokine Single Nucleotide Polymorphisms. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/cmv-infection-in-renal-transplant-recipients-incidence-and-efficacy-of-prophylaxis-according-to-cytokine-single-nucleotide-polymorphisms/. Accessed May 9, 2025.

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