Kidney transplantationComplicationThe Effect of Cytomegalovirus Antigenemia Titer on the Efficacy of Preemptive Therapy for the Prevention of Cytomegalovirus Disease After Kidney Transplantation
Section snippets
Patients
Between January 2000 and June 2007, we performed 634 consecutive kidney transplantations: 505 living donor and 129 deceased donor procedures. They were all observed until June 2008.
Study Design
The 634 consecutive kidney transplant recipients were divided into 2 groups according to the peak titer level of CMV antigenemia during CMV infections. Patients with were assigned to group A (n = 550) or B (n = 84) based on a CMV antigenemia titer of <50 or ≥50/4 × 105 leukocytes, respectively. Since January 2000,
Patient Characteristics
From January 2000 to June 2007, we performed 634 consecutive kidney transplantations. All recipients were followed for at least 1 year. Their demographic characteristics are shown in Table 1.
Comparison of Group Preoperative Variables
Deceased donor kidney transplant cases and use of ATG for induction therapy before kidney transplantation were significantly greater in group B than group A: 40.4% versus 17.2%, and 46.5% versus 9.6%, respectively. The duration of CMV antigenemia (≥50/4 × 105 leukocytes) in group B members who were
Discussion
Human CMV is one of the most important opportunistic pathogens in immunocompromised patients. Primary infections occur in 70%–88% of CMV antibody-negative recipients from CMV antibody-positive donors, whereas, CMV reinfection or reactivation occurs in 50%–80% of CMV antibody-positive recipients from CMV antibody-positive donors.11 Moreover, according to Korean reports, CMV infections occur in 36.6%–60.8% of CMV antibody-positive recipients from antibody-positive donors.12, 13 The overall
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Cited by (7)
Clinical correlates of pp65 antigenemia monitoring in the first months of post kidney transplant in patients undergoing universal prophylaxis or preemptive therapy
2017, Brazilian Journal of Infectious DiseasesCitation Excerpt :The positivity of pp65 antigenemia test can precede clinical symptoms; therefore, it is a useful tool to promptly support clinical decisions and has been considered the gold standard for monitoring HCMV viral replication in solid organ transplant recipients.9,16,17 The mean age of the donors was similar to other studies,18,19 and the positivity rate of IgG anti-HCMV was 100%. More importantly, the analyzed parameters did not differ between groups.
The effects of preemptive therapy using a very low threshold of pp65 antigenemia to prevent cytomegalovirus disease in kidney transplant recipients: A single-center experience
2013, Transplantation ProceedingsCitation Excerpt :Furthermore, the most important result was that none of the patients developed CMV symptomatic disease, a result that has not been always reached in those studies that started antiviral treatment at higher levels of pp65 CMV antigenemia.8 In a previous study, Jung et al9 divided a large cohort of kidney transplant patients into 2 groups according to their peak CMV antigenemia titer, namely <50/4 × 104 versus ≥50/4 × 104 leukocytes. They observed patient and graft survivals at 5 years posttransplantation to be similar in the 2 groups, concluding that a CMV antigenemia ≥50/4 × 104 leukocytes can be considered an appropriate guideline for preemptive anti-CMV therapy.
Outcome comparison between low-dose rabbit anti-thymocyte globulin and basiliximab in low-risk living donor kidney transplantation
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