Details

Autor(en) / Beteiligte

• De Keyzer, Kristel, MD
• Van Laecke, Steven, MD
• Peeters, Patrick, MD
• Vanholder, Raymond, PhD

Titel

Human Cytomegalovirus and Kidney Transplantation: A Clinician's Update

Ist Teil von

• American journal of kidney diseases, 2011-07, Vol.58 (1), p.118-126

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Infection with human cytomegalovirus (CMV) is an important cause of morbidity and mortality in kidney transplant recipients. CMV disease is diagnosed based on the detection of viral replication by phosphoprotein 65 antigenemia or CMV DNA polymerase chain reaction in combination with typical signs and symptoms. Risk factors include CMV-seronegative recipients receiving a CMV-seropositive transplant, older donor age, exposure to cyclosporine and/or antilymphocyte antibody, rejection episodes, and impaired transplant function. Current preventive strategies in kidney transplant recipients include pre-emptive therapy with valganciclovir or intravenous ganciclovir and universal prophylaxis with valacyclovir, valganciclovir, or ganciclovir for 3-6 months after kidney transplantation and for 1-3 months after treatment with antilymphocyte antibody. Established disease should be treated using either intravenous ganciclovir or oral valganciclovir until CMV replication can no longer be detected. In addition to direct effects, CMV infection also induces a wide range of indirect effects, such as decreased transplant and recipient survival and susceptibility to rejection and opportunistic infections. In this review, we highlight the most relevant topics on CMV and kidney transplantation based on current evidence and guidelines.