THE ADVERSE IMPACT OF CYTOMEGALOVIRUS INFECTION ON CLINICAL OUTCOME IN CYCLOSPORINE-PREDNISONE TREATED RENAL ALLOGRAFT RECIPIENTS

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Abstract
Cytomegalovirus (CMV) infection was diagnosed in 28% (n=144) of 516 renal allograft recipients treated with cyclosporine-prednisone (CsA-Pred) immunosuppressive therapy. The majority of infections produced either asymptomatic (n=37) or mild-to-moderate (n=75) clinical disease, while 10% were lethal (n=14). Transplantation from a seropositive donor to a seronegative recipient was associated with an increased incidence of (CMV) infection but did not predispose to more severe clinical disease. Similarly, donor source (cadaver [CAD] vs. living-related donor [LRD]), age ≥45 years, and antecedent pulse steroid therapy for the treatment of acute rejection were not correlated with clinically more severe disease. An increase in serum creatinine to ≥25% of preinfection nadir values occurred in association with CMV infection in 106 patients, returning to nadir values or below in 74.5% of these individuals. CMV infection