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Human Cytomegalovirus and Kidney Transplantation: A Clinician's Update

Kristel De Keyzer, Steven Van Laecke, Patrick Peeters, and Raymond Vanholder

Am J Kidney Dis 58(1):9 (2011) PMID 21684438

Infection with human cytomegalovirus (CMV) is an important cause of morbidity and mortality in kidney transplant recipients. CMV disease is diagnosed based on the detection of viral replication by phosphoprotein 65 antigenemia or CMV DNA polymerase chain reaction in combination with typical signs and symptoms. Risk factors include CMV-seronegative recipients receiving a CMV-seropositive transplant, older donor age, exposure to cyclosporine and/or antilymphocyte antibody, rejection episodes, and impaired transplant function. Current preventive strategies in kidney transplant recipients include pre-emptive therapy with valganciclovir or intravenous ganciclovir and universal prophylaxis with valacyclovir, valganciclovir, or ganciclovir for 3-6 months after kidney transplantation and for 1-3 months after treatment with antilymphocyte antibody. Established disease should be treated using either intravenous ganciclovir or oral valganciclovir until CMV replication can no longer be detected. In addition to direct effects, CMV infection also induces a wide range of indirect effects, such as decreased transplant and recipient survival and susceptibility to rejection and opportunistic infections. In this review, we highlight the most relevant topics on CMV and kidney transplantation based on current evidence and guidelines.

Copyright © 2011 Elsevier Ltd. All rights reserved.

DOI: 10.1053/j.ajkd.2011.04.010
Version: za2963e q8za8 q8zbb q8zca q8zda q8ze5 q8zff q8zga

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