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 8, 2024.« Back to 2018 American Transplant Congress