Cytomegalovirus disease in African-American kidney transplant patients

J. McGee, V. Mave, C. L. Yau, M. Killackey, A. Paramesh, J. Buell, D. P. Slakey, L. L. Hamm, R. Zhang

Research output: Contribution to journalArticle

Abstract

Background: Cytomegalovirus (CMV) disease is a serious infection after kidney transplantation. The risk factors and the impact of CMV disease in African-American (AA) kidney transplant patients have not been well characterized. Methods: We performed a retrospective analysis on 448 AA patients transplanted between 1996 and 2005. A 3-month universal chemoprophylaxis with ganciclovir or valganciclovir was administered to CMV donor-positive/recipient-negative (D+/R-) patients and to those treated with anti-thymocyte globulin for rejection, but not routinely to those with other D/R serostatus. Results: A total of 31 AA patients (7%) developed clinical CMV disease. Compared with other D/R serostatus groups, the D+/R- group had the highest 3-year cumulative incidence of CMV disease (16.9% vs. 6.3% in D+/R+, 4.9% in D-/R+, and 2.4% in D-/R-). The D+/R- group also had the worst 3-year death-censored allograft survival (75% vs. 92% in D+/R+, 94% in D-/R+, and 96% in D-/R-, log-rank P = 0.01). Multivariate analysis found that D+/R- serostatus (odds ratio [OR] 5.4, 95% confidence interval [CI] 0.6-48.2, P = 0.003) and donor age > 60 years (OR 9.1, 95% CI 1.3-65, P = 0.03) were independent risk factors for CMV disease. Conclusion: The D+/R- group has the highest incidence of CMV disease and the worst 3-year renal allograft survival despite 3-month universal prophylaxis. Prolonged chemoprophylaxis may be needed to prevent the late development of CMV disease and to improve allograft survival in the high-risk group of AA kidney transplant recipients.

Original languageEnglish (US)
Pages (from-to)604-610
Number of pages7
JournalTransplant Infectious Disease
Volume14
Issue number6
DOIs
StatePublished - Dec 2012
Externally publishedYes

Keywords

  • African-American
  • CMV prophylaxis
  • Cytomegalovirus
  • Graft survival
  • Kidney transplant

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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  • Cite this

    McGee, J., Mave, V., Yau, C. L., Killackey, M., Paramesh, A., Buell, J., Slakey, D. P., Hamm, L. L., & Zhang, R. (2012). Cytomegalovirus disease in African-American kidney transplant patients. Transplant Infectious Disease, 14(6), 604-610. https://doi.org/10.1111/j.1399-3062.2012.00759.x