Study: Kidney Recipients Remain at "High Risk" of Hospitalization for CMV

Even in the modern era, kidney transplant recipients remain at "high risk" for hospitalizations for cytomegalovirus (CMV) disease, according to researchers from Walter Reed Army Medical Center.

The virus, a member of the herpes group which infects more than half of all adults in the United States by age 40, has few symptoms and no long-term health consequences for most.

But it remains one of the major causes of illness and death in immunosuppressed transplant recipients, and major efforts have focused on reducing the risk of CMV disease for these patients.

The researchers reported that in analyzing data for more than 33,000 kidney transplants from mid-1994 to mid-1997, patients without the CMV virus who received kidneys from donors who carried the CMV virus had the highest risk of hospitalization for CMV disease.

"Current prophylactic measures have apparently not reduced the high risk" for CMV negative recipients who get kidneys from CMV positive donors, the researchers reported in the journal Annals of Epidemiology

The Walter Reed researchers said that in analyzing risk factors, pre-transplant dialysis for more than six months or taking the immunosuppressive drug mycophenolate mofetil also appeared to result in a "significantly" higher risk of hospitalized CMV disease.

"Prolonged pre-transplant dialysis and maintenance MMF should be considered risk factors for hospitalized CMV infection, and prospective trials of prophylactic antiviral therapy should be performed in these subgroups," the researchers concluded.