Relation between Seroprevalence of Cytomegalovirus and Graft Survival in Japanese Kidney Transplant Recipients: The Japan Academic Consortium of Kidney Transplantation Study

K. Miyake,^1,2 M. Okumi,¹ K. Unagami,³ Y. Kakuta,¹ H. Shirakawa,⁴ K. Omoto,⁵ H. Ishida,¹ K. Tanabe.¹

¹Urology, Tokyo Women's Medical University, Tokyo, Japan
²Kidney Transplantation, Shonan Kamakura General Hospital, Kamakura, Japan
³Nephrology, Tokyo Women's Medical University, Tokyo, Japan
⁴Urology, Okubo Hospital, Tokyo, Japan
⁵Urology, Toda Chuo General Hospital, Saitama, Japan.

Meeting: 2018 American Transplant Congress

Abstract number: A175

Keywords: Cytomeglovirus, Kidney transplantation, Survival

Session Information

Session Name: Poster Session A: Kidney Transplant Goes Viral

Session Type: Poster Session

Date: Saturday, June 2, 2018

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

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

Location: Hall 4EF

Background

Cytomegalovirus (CMV) infection is one of major causes of morbidity in kidney transplant recipients (KTRs). However, the current prevalence of CMV in KTRs and the risk of graft loss have not been well-studied in Japan.

Methods

1004 Japanese adult KTRs who had undergone living kidney transplantation from 1996 to 2013 in our institutions were divided into four groups: serological status of D+/R+ (n=814), D+/R- (n=130), D-/R+ (n=35), and D-/R- (n=25).

KTRs were tested for the presence of CMV using an antigenemia assay post-transplant, and categorized as CMV viremia (antigenemia positive without symptoms), CMV syndrome (antigenemia positive with symptoms), and tissue-invasive CMV disease (antigenemia positive with tissue invasion).

The incidence of CMV infection/disease and rejection rate, and transplant outcomes were analyzed and compared between high-risk (D+/R-) and intermediate-risk KTRs (D+/R+ or D-/R+), all managed with preemptive therapy.

Results

We found that 84.6% of KTRs and 94.0% of corresponding donors were CMV seropositive. The D+/R- group showed a high incidence of CMV viremia (70.8% vs 12.1%, p<0.001), CMV syndrome (26.9% vs 1.2%, p=0.018), and tissue-invasive CMV disease (8.5% vs 0.7%, p<0.001). However, there were no significant differences between D+/R+ and D+/R- groups in the incidence of antibody-mediated rejection (8.0% vs 5.4%, p=0.963), T-cell mediated rejection (8.0% vs 8.5%, p=0.661), or graft loss (1.8% vs 0.8%, p=0.603).

Conclusion

While the D+/R- group had higher risk for CMV infection than the D+/R+ group in Japanese KTRs, there were no significant differences in the incidence of rejection and graft loss even under the management of preemptive therapy against CMV.

CITATION INFORMATION: Miyake K., Okumi M., Unagami K., Kakuta Y., Shirakawa H., Omoto K., Ishida H., Tanabe K. Relation between Seroprevalence of Cytomegalovirus and Graft Survival in Japanese Kidney Transplant Recipients: The Japan Academic Consortium of Kidney Transplantation Study Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Miyake K, Okumi M, Unagami K, Kakuta Y, Shirakawa H, Omoto K, Ishida H, Tanabe K. Relation between Seroprevalence of Cytomegalovirus and Graft Survival in Japanese Kidney Transplant Recipients: The Japan Academic Consortium of Kidney Transplantation Study [abstract]. https://atcmeetingabstracts.com/abstract/relation-between-seroprevalence-of-cytomegalovirus-and-graft-survival-in-japanese-kidney-transplant-recipients-the-japan-academic-consortium-of-kidney-transplantation-study/. Accessed November 21, 2024.

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