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Cytomegalovirus and paediatric renal transplants: is this a current issue?

Julia Fijo-López-Viota1, Laura Espinosa-Román, Carlos Herrero-Hernando

  • 1Unidad de Nefrología Pediátrica. Servicio de Pediatría. Hospital Universitario Virgen del Rocío. Sevilla (Spain). mj.fijo.sspa@juntadeandalucia

Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|February 1, 2013
PubMed

Insights

Cytomegalovirus (CMV) infection occurred in 24.26% of pediatric kidney transplant recipients, with disease in 6.7%. Chemical prophylaxis is the primary strategy, with incidence linked to donor/recipient serology and prophylaxis duration.

Area of Science:

  • Pediatric Nephrology
  • Transplant Infectious Diseases
  • Immunocompromised Host Management

Background:

  • Cytomegalovirus (CMV) remains a significant concern in pediatric kidney transplantation.
  • Understanding CMV epidemiology and risk factors is crucial for effective management and prevention strategies.
  • This study provides baseline data on CMV before a large-scale prophylaxis trial.

Purpose of the Study:

  • To evaluate the current situation of cytomegalovirus (CMV) in pediatric kidney transplant recipients.
  • To identify risk factors associated with CMV infection and disease.
  • To inform participation in an international clinical trial on CMV prophylaxis.

Main Methods:

  • Retrospective, multicenter observational study.
  • Inclusion of 239 pediatric patients (<19 years) undergoing kidney transplantation.
  • 1-year follow-up period with analysis of pretransplant serology, prophylaxis use, and CMV outcomes.

Main Results:

  • CMV viraemia occurred in 24.26% and CMV disease in 6.7% of patients.
  • High-risk status (Donor-positive/Recipient-negative, D+/R-) was identified in 25.1% of patients.
  • CMV infection was significantly associated with D+/R- serological status (P<.001) and shorter prophylaxis duration (<20 days, P<.05).

Conclusions:

  • Chemical prophylaxis is the primary preventative strategy (81% use) in Spain for CMV in pediatric kidney transplants.
  • The incidence of CMV infection and disease was 24.26% and 6.7%, respectively, with no patient or graft loss.
  • Key risk factors for CMV infection include D+/R- serological status and inadequate prophylaxis duration.
Abstract

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