ESPN 51th Annual Meeting

ESPN 2018


 
CYTOMEGALOVIRUS INFECTION IN PEDIATRIC KIDNEY TRANSPLANTATION
Sevgin Taner 1 Ipek Kaplan Bulut 1 Ahmet Keskinoglu 1 Aysin Zeytinoglu 2 Sedef Oksuz 3 Taylan Ozgur Sezer 4 Pembe Keskinoglu 5 Caner Kabasakal 1

1- Ege University Faculty of Medicine, Department of Pediatric Nephrology
2- Ege University Faculty of Medicine, Department of Medical Microbiology
3- Ege University Faculty of Medicine, Pediatrics
4- Ege University Faculty of Medicine, Surgery
5- Dokuz Eylul University Faculty of Medicine, Department of Biostatistics and Medical Informatics
 
Introduction:

Cytomegalovirus (CMV) infection is an important factor affecting graft function and graft survival in renal transplantation. In this study, CMV infection and its effect on kidney dysfunction were evaluated in pediatric kidney transplant recipients.

Material and methods:

We performed a retrospective study including 93 children with kidney transplantation, followed at Ege University Pediatric Nephrology Department.  

Results:

Ninety-three patients (59.1% male, 40.9% female; 54.8% living donor, 45.2% cadaveric donor) were evaluated. CMV IgG detected positive in 80 patients (CMV R+), negative in 9 with positive respective donors (CMV R−D+) and negative in 4 with negative respective donors (CMV R−D−). Twenty-three of the patients developed CMV infection after transplantation and all were treated. The CMV infection frequency was higher in patients with cadaveric donors than with living donors (p = 0.007). The incidence of CMV infection in R− recipients was higher than R+ recipients regardless of donor serologic status (p = 0.001). Graft dysfunction was observed in 23 patients; 12 of these had CMV infection. Graft dysfunction rate was 52.2% in patients who had CMV infection and 15.7% in who had not. The frequency of graft dysfunction in patients with CMV infection was significantly higher (p <0.001). According to the results of Kaplan Meier analysis the presence of renal dysfunction after transplantation is endpoint, and CMV infection is being factor in the model; survival time of CMV patients is significantly shorter. According to the cox regression analysis with variables CMV infection and HLA-mismatch, the presence of CMV infection was found to affect renal dysfunction significantly.

Conclusions:

CMV infection is an important risk factor affecting graft function and renal survive in children with kidney transplantation. Patients and donors should be evaluated and patients with CMV infection have to be followed and treated carefully to improve kidney transplantation outcome.