T-H CHEN1, S OU1, D TARNG1
1 Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Background: Previous studies demonstrated that cytomegalovirus (CMV) infection was associated with increased risk for renal allograft rejection, graft loss and mortality in kidney transplant recipients. Anti-CMV IgG, an antibody that appeared in the blood after 6 to 8 weeks of CMV infection, usually persisted after primary infection. However, the association between anti-CMV IgG titer and the risks of renal outcomes have never been explored. This study aimed to explore the role of anti-CMV IgG titer on the risks of development of CMV infection, allograft rejection, renal function decline and mortality.
Methods: We conducted a hospital-based study including180 CMV-seropositive kidney transplant recipients between 2013 and 2017. Patients were divided into high anti-CMV IgG titer (≥1:800) and low (<1:800) groups. The outcomes included CMV infection, ≥15% decrease in estimated glomerular filtration rate (eGFR), biopsy-proven allograft rejection and mortality.
Results: Compared with low anti-CMV IgG titer group, high anti-CMV IgG titer group had higher risks of renal allograft rejection (hazard ratio [HR], 2.85; 95% confidence interval [CI], 1.17–8.55; P = 0.035), eGFR decline>15% (HR, 1.71; 95% CI, 1.03–2.97; P = 0.045), CMV infectious disease (HR, 3.16; 95% CI, 1.35–9.27; P = 0.017) but the risk for all-cause mortality showed no difference. The results were similar after adjustment by the value of serum CMV polymerase chain reaction as a time-dependent variable.
Conclusions: In conclusion, we found that kidney transplant recipients with high anti-CMV IgG titer had higher risks of development of CMV infection and allograft rejection than those with low titer.
I am Dr. Tz-Heng Chen. I was born in Taipei, Taiwan in 1986. I received my medical degree from the National Yang-Ming University. After graduation, I completed my residency in Internal Medicine at Taipei Veterans General Hospital. Now, I am a first year fellow in Nephrology and doing clinical research in the field of kidney transplantation at Taipei Veterans General Hospital.