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The risk of cytomegalovirus infection (CMV) after rejection treatment is poorly understood. To investigate this, we conducted a case/control(1:2) analysis of adult renal-transplant recipients between 1/1/2005-12/31/2015 via incidence-density sampling and survival analysis. Our objective was to evaluate the association of prior acute-rejection with subsequent CMV, including epidemiology and outcomes. There were 2481 eligible renal-transplants within the study period and 251 distinct CMV infections. Despite the use of antiviral prophylaxis rejection was a significant risk factor for CMV on unadjusted (HR 1.73(1.34,2.24),p<0.05) and adjusted analysis (HR 1.46(1.06,2.04),p<0.05). When matching cases to controls patients with CMV had significantly more rejection prior to CMV diagnosis (26.7%vs14.2%,p<0.01). CMV was associated with a two-fold increased risk of prior rejection on unadjusted(OR 1.94,95%
1.28-2.96,p<0.01) and adjusted analysis(OR 2.16,95%
1.31-3.58,p<0.01). Patients with rejection preceding CMV had significantly increased graft loss (HR 2.89,95%
1.65-5.09,p<0.01) and mortality (HR 1.82,95%
1.12-4.24,p=0.03) as compared to those CMV cases without rejection. In conclusion, rejection is a risk factor for CMV infection that appears to persist for 1 year. Preceding rejection events increased risk of graft loss and mortality in CMV patients. Given this, prolonged surveillance monitoring for CMV after rejection may be warranted. Studies are needed investigating optimal monitoring strategies. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Clinical transplantation
The complex interaction betweencytomegalovirus (CMV) infection and acute rejection after kidney transplantation is well recognized.
Data are scarce on cytomegalovirus (CMV) and BK virus (BKV) infection after antibody-mediated rejection (ABMR).
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The purpose of this study is to assess the risk of congenital cytomegalovirus (cCMV) infection in newborns born to seropositive women.
Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness.
Infection with CYTOMEGALOVIRUS, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults.
A genus of the family HERPESVIRIDAE, subfamily BETAHERPESVIRINAE, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS.
An isoquinoline derivative that prevents dopamine reuptake into synaptosomes. The maleate was formerly used in the treatment of depression. It was withdrawn worldwide in 1986 due to the risk of acute hemolytic anemia with intravascular hemolysis resulting from its use. In some cases, renal failure also developed. (From Martindale, The Extra Pharmacopoeia, 30th ed, p266)
Vaccines or candidate vaccines used to prevent infection with CYTOMEGALOVIRUS.
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Nephrology - kidney function
Nephrology is a specialty of medicine and pediatrics that concerns itself with the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy (dialysis and kidney transplantation). Systemic conditions...
Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative ...