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Subclinical Cytomegalovirus Viraemia in Renal Transplant Recipients.

K. Barker,1 N. Cook,1 P. Kevan,2 I. Frank.1

1Renal Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia
2Renal Unit, Monash Medical Centre, Melbourne, Victoria, Australia.

Meeting: 2016 American Transplant Congress

Abstract number: D245

Keywords: Cytomeglovirus, Ganciclovir, Kidney transplantation, Prophylaxis

Session Information

Date: Tuesday, June 14, 2016

Session Name: Poster Session D: Poster Session II: Kidney Complications-Other

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

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  • Low Dose Valganciclovir Is an Effective Prophylaxis Against Cytomegalovirus in High Risk (Donor+/ Recipient-) Kidney Transplants Recipients

Background: Studies suggest low-level cytomegalovirus (CMV) viraemia, detected with sensitive molecular assays, may lead to poorer graft outcomes following renal transplantation.

Aims: Investigate the incidence, outcomes, and clinical associations of subclinical CMV viraemia in adult renal transplant recipients.

Methods: A retrospective cohort study from January 2010 to March 2012 with 3 years follow up.

Results: 22/59 patients were diagnosed with subclinical viraemia. 8/22 cases occurred whilst receiving anti-viral prophylaxis. Renal function was similar at 12, 24 and 36 months in both CMV viraemic and non-viraemic patients. Total rejection was not different (p=0.13) between groups. Anti-viral prophylaxis was under-dosed when corrected for GFR at day 7 in 83.3% of patients who developed viraemia on prophylaxis, compared to 23.1% of patients with viraemia after prophylaxis stopped and 22.7% of patients who were never viraemic (p=0.03). By 21 days there was no significant difference in prophylaxis dosing between groups. In those who developed CMV during prophylaxis the percentage improvement in GFR at 14 to 28 days was 161.7% compared to 49.7% in the CMV after prophylaxis and 36.3% in the never viraemic group p=0.001. Median time on dialysis post transplant was higher in those who later developed subclinical viraemia p=0.01 (Figure1)

Conclusion: Subclinical CMV viraemia is common and associated with early dialysis requirements following transplantation. Early under-dosing of antiviral prophylaxis was significantly associated with rapid improvement in GFR and a risk factor for subclinical CMV during the prophylaxis period. Accurate early prophylaxis dosing and CMV surveillance may benefit patients with delayed graft function.

CITATION INFORMATION: Barker K, Cook N, Kevan P, Frank I. Subclinical Cytomegalovirus Viraemia in Renal Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Barker K, Cook N, Kevan P, Frank I. Subclinical Cytomegalovirus Viraemia in Renal Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/subclinical-cytomegalovirus-viraemia-in-renal-transplant-recipients/. Accessed March 4, 2021.

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