NDLI: Long-term impact of CMV infection on allografts and on patient survival in renal transplant patients with protocol biopsies.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Erdbrügger, U. Scheffner, I. Mengel, M. Schwarz, A. Haller, H. Gwinner, W.
Spatial Coverage	Germany
Description	Author Affiliation: Erdbrügger U ( Division of Nephrology and Hypertension, University of Virginia Health System, Charlottesville, Virginia); Scheffner I ( Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany); Mengel M ( Department of Laboratory Medicine and Pathology, University of Edmonton, Edmonton, Ontario, Canada.); Schwarz A ( Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany); Haller H ( Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany); Gwinner W ( Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany)
Abstract	Cytomegalovirus (CMV) infection is a frequent complication of early posttransplantation. This study examines its impact on chronic allograft changes, long-term graft loss, and patient survival. We studied 594 patients who had protocol biopsies at 6 wk, and 3 and 6 mo posttransplantation. Chronic allograft changes were evaluated according to the updated Banff classification [interstitial fibrosis/tubular atrophy (IF/TA), vascular and glomerular lesions]. Follow-up data were available for up to 10 yr. CMV infection was diagnosed in 153 of 594 patients (26%) in the first year after transplantation, mostly within the first 3 mo. Graft survival was reduced in patients with CMV (P = 0.03) as well as the combined allograft/patient survival (P = 0.008). Prevalence of IF/TA at 6 wk after transplantation was already threefold higher in patients who experienced CMV infection later on compared with patients without CMV (P = 0.005). In multivariate analyses, CMV viremia or disease was not a significant factor for graft loss or death. In conclusion, patients with CMV infection posttransplantation show more chronic allograft changes early on, even before CMV infection, and development of IF/TA is not more prevalent in patients with CMV. Our data do not support a significant role of CMV in patient and graft outcomes.
File Format	HTM / HTML
ISSN	1931857X
Issue Number	11
Volume Number	309
e-ISSN	15221466
Journal	AJP: Renal Physiology
Language	English
Publisher	American Physiological Society
Publisher Date	2015-12-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Chi-square Distribution Kaplan-meier Estimate Multivariate Analysis Immunosuppressive Agents Humans Middle Aged Male Predictive Value Of Tests Epidemiology Kidney Journal Article Incidence Atrophy Discipline Physiology Allografts Time Factors Etiology Surgery Adult Female Retrospective Studies Adverse Effects Glomerular Filtration Rate Mortality Risk Factors Proportional Hazards Models Cytomegalovirus Infections Discipline Nephrology Graft Survival Treatment Outcome Kidney Transplantation Therapeutic Use Physiopathology Pathology Biopsy Fibrosis Germany
Content Type	Text
Resource Type	Article
Subject	Physiology Urology

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