Cytomegalovirus Infection following Kidney Transplantation: a Multicenter Study of 3065 Cases

Background: Cytomegalovirus (CMV) infection is a common complication following kidney transplantation.Objective: To assess the incidence and risk factors of CMV infection among renal transplant recipients.Methods: In a retrospective multicenter study, 3065 renal transplant recipients from 17 transplant centersof Iran were studied between April 2008 and January 2011. Kidney transplant patients were routinelymonitored by sequential blood samples drawn for use in the CMV-pp65 antigenemia assay, and forhematological and biochemistry tests.Results: 63% of studied patients were males; the mean±SD age of participants was 38±15 years. Themajority of cases (81%) received a kidney from a living unrelated donor (LURD), 9% from living relateddonor (LRD), and 10% from deceased donors. 671 patients experienced CMV viremia. The incidenceof CMV infection was 21.9% (95% CI: 20.4%–23.4%). The rate was higher in the first 6 months aftertransplantation (p<0.001); in recipients with higher level of cyclosporine (p<0.001); in those with lowerhemoglobin concentration (p=0.02); patients with elevated ALT (p<0.001); those with increased fastingblood sugar (p=0.005); recipients with dyslipidemia (p<0.05); deceased kidney recipients (p=0.006); andpatients with kidney graft impairment (p=0.01). In multivariate regression analysis, time since kidneytransplantation (p<0.001) and renal allograft failure (p<0.001) were the only risk factors associated withCMV infection.Conclusions: CMV infection was a common complication in the first 6 months of kidney transplantation,particularly among patients with kidney graft impairment.