| Autor: |
McGee, J., Mave, V., Yau, C.L., Killackey, M., Paramesh, A., Buell, J., Slakey, D.P., Hamm, L.L., Zhang, R. |
| Předmět: |
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| Zdroj: |
Transplant Infectious Disease; Dec2012, Vol. 14 Issue 6, p604-610, 7p, 3 Charts, 1 Graph |
| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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