Impact of Cytomegalovirus on Long-term Mortality and Cancer Risk After Organ Transplantation. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Desai, Rajeev; Collett, Dave; Watson, Christopher J. E.; Johnson, Philip J.; Moss, Paul; Neuberger, James
• Is Part Of: Transplantation. Volume 99:Issue 9(2015)
• Publication Date: 2015-09
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000641
• Languages: English
• ISSNs: 0041-1337

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p>There is conflicting evidence of the effect of cytomegalovirus (CMV) infection on survival and the risk of cancer after transplantation.</p> </sec> <sec> <title>Methods</title> <p>All recipients of kidney, liver, heart, and lung transplants in the United Kingdom between 1987 and 2007 with known CMV immunoglobulin G status were identified from the U.K. Transplant Registry. Based on the donor-recipient CMV status, recipients were grouped into: donor (D) negative recipient (R) negative (D− R−), D−R+, D + R+ and D + R−. Cancer data were obtained from the Office for National Statistics. The impact of CMV infection on survival and cancer incidence was assessed.</p> </sec> <sec> <title>Results</title> <p>The 10-year posttransplant survival in D−R− recipients (73.6% [95%CI, 72.3, 74.9]) was significantly higher (<italic>P</italic> < 0.0001) than in other recipients (66.1% [65.3, 66.9]). Compared with the D− R− group, the risk-adjusted hazard of death within 10 years of transplantation for D+ R− group was 14% higher for kidney recipients (<italic>P</italic> = 0.0495), 13% higher for liver recipients (<italic>P</italic> = 0.16), 34% higher for heart recipients (<italic>P</italic> = 0.01), and 35% higher for lung recipients (<italic>P</italic> = 0.006). The proportion of recipients with a cardiovascular cause of death was higher (<italic>P</italic> = 0.03) among the recipients exposed to CMV (18%) as compared to the D− R− recipients (16%). The CMV status was not associated with an increased risk of cancer.</p> </sec> <sec> <title>Conclusions</title> <p>The results from this large study demonstrate that CMV is associated with a significantly increased long-term mortality in kidney and cardiothoracic transplant recipients and an increased risk of cardiovascular death but not of posttransplant cancer.</p> </sec> </abstract>