*Purpose: It has been reported that everolimus (EVR) administration reduces the incidence of cytomegalovirus (CMV) infection, but clinical outcome in CMV-seronegative recipients with EVR-based regimen as immunosuppressive induction therapy is unclear.

*Methods: 41 Patients with CMV-seronegative who underwent living-related kidney transplant (KT) from CMV-seropositive donors were enrolled. Among 41, 25 recipients were treated with EVR in addition to tacrolimus (TAC), mycophenolate mofetil (MMF) and only 3 doses of perioperative methylprednisolone (EVR group). Historical control group was composed of 16 recipients who received TAC/MMF with or without methylprednisolone (Control group). Basiliximab was also used as induction mAb in each group. All CMV-seronegative recipients received valganciclovir(VGCV) for prophylaxis until 4 months post kidney transplantation. The incidence within 1 year and the time of primary CMV infection, the incidence of CMV disease which required ganciclovir(GCV), and the rate of CMV-antibody acquisition were analyzed retrospectively.

*Results: There were no statistical differences between the two groups in age at transplant, gender, high-risk immunosuppression, incidence of acute rejection within 1 year and prophylactic administration period. The incidence of primary CMV infection within 1 year was 68% for both, while the time of occurrence (months after transplantation) was significantly later in the EVR group (EVR: 7.8 months, Control: 6 months, p=0.04)) (Fig.1). In addition, there were significantly fewer cases of CMV disease requiring GCV with EVR. (EVR: 52%, Control: 90%, p=0.04) (Fig.2). There was also no statisticaldifference in the acquisition rate of CMV-antibody. (EVR: 80%, Cont: 87%)

*Conclusions: EVR as immunosuppressive induction therapy could delay the primary CMV infection after discontinuation of prophylactic VGCV and suppress the development of CMV disease.

« Back to 2022 American Transplant Congress