CMV infection and disease in kidney and pancreas transplant recipients

Although the frequencies of renal and pancreas allograft transplantation are disparate, many of the questions concerning CMV and optimal patient management are the same. Risk factors for cytomegalovirus (CMV) disease in kidney and pancreas transplant patients include serologic mismatch and high-level immunosuppression; bladder drainage of pancreas allografts also appears to increase the rates of CMV reactivation and of urinary tract infections. Additionally, reduced allograft survival has been documented in patients with active CMV infection, via both direct and indirect effects. Prevention of CMV replication and disease is therefore an important aspect of management of both patient populations, and studies of CMV prophylaxis in these patient groups are discussed.