engleski

PREVENTION OF CYTOMEGALOVIRUS DISEASE AFTER RENAL TRANSPLANTATION - A SINGLE CENTER EXPERIENCE

INTRODUCTION: According to the current guidelines prophylactic treatment for Cytomegalovirus (CMV) is recommended in solid organ transplantation. We were interested to explore the prevalence of CMV viremia/disease due to use of prophylactic treatment in our renal transplant recipients (RTRs). METHODS: We retrospectively examined the 24-year (1990-2014) data of 521 RTRs mean age 48.9±13.6 years. On the pretransplant CMV antibody assay, prophylaxis for CMV disease is performed for the following donor/recipient subgroups: Donor (D)+ and Recipient (R)+, D+/ R- and D-/R+. The dose of valacyclovir was adjusted according to renal function. RESULTS: 95 RTRs were received prophylaxis for CMV and 426 patients didn’t received prophylactic treatment. Prophylactic treatment significantly reduced the incidence of CMV disease during the first-year after transplantation (8.45% vs. 2.1% ; p=0.05). Although the prevalence of CMV viremia was higher in the group of patients that didn’t received prophylaxis, that difference was not statistically significant (9.6% vs. 3.2% ; p=0.07). The mean values of serum creatinine didn’t showed any significant differences after one-year of follow-up between the RTRs who had received prophylaxis in comparison to the patients that didn’t received prophylactic treatment (127.7±65.2 vs. 145.1±87 ; p=0.09). In the group of patients that didn’t received prophylactic treatment 15.5% of patients loss their graft during the first year after transplantation, while in the group of patients with prophylactic treatment 6.3% of RTRs loss their graft in the same period. In the group of patients that had received prophylaxis the main reasons for graft loss were an acute rejection (6.1%) and surgical complications (4.9%), while surgical complications (3.2%) and chronic allograft nephropathy (2.1%) were the most common reasons for graft loss in the second group of RTRs. There were no significant differences in the one-year patients survival between the two groups of patients (p=NS). CONCLUSION: Prophylactic treatment for CMV is an effective way to prevent CMV disease after renal transplantation.

CMV; transplantation

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