Risk Factors for the Development of Cytomegalovirus Resistance in Solid Organ Transplantation: A Retrospective...

Area of Science:

• Transplant Medicine
• Infectious Diseases
• Virology

Background:

• Cytomegalovirus (CMV) resistance is a growing concern in solid organ transplant (SOT) recipients.
• Risk factors contributing to CMV resistance remain incompletely understood.

Purpose of the Study:

• To identify risk factors associated with the development of genotypic Cytomegalovirus resistance in SOT recipients.
• To compare patient groups with proven CMV resistance, refractory CMV infection, and no suspected resistance.

Main Methods:

• Retrospective analysis of SOT recipients with CMV viremia undergoing resistance testing (January 2010 - March 2016).
• Patients categorized into proven CMV resistance, refractory infection, and control groups.
• Statistical analysis to identify factors associated with CMV genotypic resistance.

Main Results:

• Eleven of 49 (22.45%) patients developed genotypic CMV resistance.
• Higher prednisone and tacrolimus levels, lack of antiviral response, and increased fungal infections were associated with CMV resistance.
• CMV resistance was less frequent in liver and kidney recipients compared to heart, small bowel, and multi-visceral recipients.

Conclusions:

• Persistent clinical disease despite antiviral therapy is a significant risk factor for CMV resistance, potentially linked to high immunosuppression.
• CMV resistance did not significantly impact graft loss or overall survival in this cohort.