Impact of cytomegalovirus infection on recipients of kidney transplantation and its risk factors / 中华肾脏病杂志

ABSTRACT

Objectives To investigate the influence of cytomegalovirus infection after kidney transplantation on the recipients and the associated risk factors of cytomegalovirus infection .Methods Data of 892 kidney transplantation recipients from January 2000 to December 2004 in our department were analyzed retrospectively . All the recipients were divided into case group (with cytomegalovirus infection) and control group (without cytomegalovirus infection) . Log-Rank test was used to compare the 1-, 3-, 5-year survival of patients and grafts between two groups . The incidence of complications, the difference of regiment of immunosuppressant and anti-CMV drugs were compared as well . The independent risk factors of cytomegalovirus infection were assessed by Logistic regression analysis . Results One-, 3-, 5-year survival rates of patients in case group were 81 .3%, 72 .8% and 54 .8% respectively, while the patients in control group were 96 .4%,91 .4% and 79 .9% respectively, the prior was significantly lower than the latter (Log-Rank value=49 .62, P＜0 .01) . One-, 3-, 5-year survival rates of grafts in case group were 71 .0%, 66 .2% and 46 .1%, while the grafts in control group were 91 .5%, 86 .6% and 74 .5% respectively, the prior was significantly lower than the latter as well (Log-Rank value=44 .87, P＜0 .01) . The incidence of acute rejection in case group was 24 .9%, while it was 13 .9% in control group, with significant difference between two groups (x2=14 .49, P＜0 .01 ) . Logistic regression showed that acute rejection,mycophenolate mofetil dose more than 2 g, and usage of ATG/ALG or OKT3 were the independent risk factors of cytomegalovirus infection (OR=1 .464, 3 .097 and 2 .837, P＜0 .05 ) . Ganciclovir was the protective factor of cytomegalovirus infection (OR =0 .234, P ＜0 .01) . Conclusions Cytomegalovirus infection decreases the long-term survival of recipients and grafts in kidney transplantation . Acute rejection, high dose of mycophenolate mofetil, and ATG/ALG or OKT3 are the independent risk factors of cytomegalovirus infection . Prophylactic usage of ganciclovir after kidney transplantation can effectively reduce cytomegalovirus infection .