Post-Transplant CMV Infection Hits GI Tract Hardest

SEATTLE—Gastrointestinal (GI) symptoms are the most common manifestation of cytomegalovirus (CMV) infections after kidney transplantation, researchers reported at the 2013 American Transplant Congress.

GI symptoms occurred in 58% of CMV seronegative recipients (R-) who acquired CMV infection from an infected donor and 46% of those who were CMV seropositive at the time of transplantation (R+). The second most common symptom was a fever greater than 38˚ C (100.4˚ F), which occurred in 47% and 27% of patients, respectively.

The study, by Ilkka Helantera, MD, of the University of Helsinki in Finland, and collaborators included 1,129 kidney transplant recipients. CMV disease occurred in 217 (19.2%) and CMV infection occurred in 297 (26.3%).

Tissue-invasive CMV gastroenteritis was confirmed in 11% and CMV pneumonia in only 1% of patients with CMV disease. Only one patient died due to CMV infection (mortality 0.3%). Recurrent CMV infection occurred in 33% patients.

Graft dysfunction, hepatopathy, malaise, and respiratory tract problems were relatively uncommon. For example, graft dysfunction occurred in 9% of R- patients and 12% of R+ patients, and hepatopathy occurred in 11% and 7% of patients, respectively.

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