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2013, Cilt 43, Sayı 3, Sayfa(lar) 084-089
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Evaluation of the Frequency of CMV Infection and Risk Factors in Kidney Transplant Patients Who are Receiving CMV Prophylaxis
Alparslan ERSOY1, Ahmet GÜLTEPE2, Emel IŞIKTAŞ SAYILAR1, Yavuz AYAR1, Halis AKALIN3, Fatih COŞKUN2, Meltem ÖNER TORLAK3, Gökhan COŞGUN2, Coşkun ATEŞ2
1Uludağ Üniversitesi Tıp Fakültesi, Nefroloji Bilim Dalı
2Uludağ Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı
3Uludağ Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı
Keywords: Cytomegalovirus infection, kidney transplantation, immunosuppression

Objective: Cytomegalovirus (CMV) is the most common viral pathogen isolated in kidney transplant patients. CMV infections may increase the risk of acute rejection, and lead to graft failure, patient death, opportunistic infections, malignancy, diabetes, and cardiovascular complications. Prophylactic antiviral therapy after transplantation is the most effective strategy to reduce the incidence of CMV infections. In this study, we aimed to investigate the incidence of CMV infection and risk factors in kidney transplant recipients who received valganciclovir prophylaxis.

Materials and Methods: A total of 126 kidney transplant patients who received oral valganciclovir prophylaxis and underwent kidney transplantation due to end-stage renal disease in our center were included in the study. CMV infection was evaluated with CMV-DNA positivity measured by Abbott Real Time PCR technique. The patients were divided into two groups as CMV-DNA positive and negative and their features were compared.

Results: Of 126 kidney translant recipients, 35 (27.7%) had CMV-DNA positivity. Demographic characteristics of CMV-DNA positive and negative recipients were similar. There was no difference between acute rejection rates and kidney functions. CMV-DNA positivity rates were comparable in the patient groups receiving cyclosporin or tacrolimus-based immunosuppressive agents (35% vs. 21.2%, p>0.05, respectively). The frequency of anti-thymocyte globulin (ATG) use due to acute rejection was significantly higher in the recipients with CMV infection (22.8% vs. 8.7%, p=0.038). In addition, CMV infection occurred in 50% of the patients who were given ATG.

Conclusion: CMV infection is a significant cause of morbidity and mortality in transplant recipients and antibody therapies used for induction or rejection are the major factors responsible from development of CMV infection. It will be useful to follow-up CMV-DNA copies regularly in the recipients who receive antibody treatment and effective prophylaxis strategies should be established in these patients.


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