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

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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.