Transmission of cytomegalovirus infection with renal allograft

Abstract

A group of 54 patients who received a renal allograft between October 1971 and October 1974 were followed prospectively to correlate pretransplant serum antibody to cytomegalovirus (CMV) with shedding of CMV following transplantation. In 25 of the 54 patients antibody to CMV was demonstrable using immunofluorescent techniques, but only 20 of 54 using complement fixing techniques. All 24 who had antibody and survived 1 mth or longer, and 7 of 9 without antibody but who received a kidney from a seropositive donor shed virus after transplantation, whereas none of 12 individuals without antibody and who received a kidney from a seronegative donor (P>0.005) shed virus. Three of 8 other seronegative patients for whom donor sera were not available for analysis shed virus. Viremia occurred in 8 of 10 individuals who developed new antibody after transplantation, versus 7 of 24 with antibody prior to transplant (P<0.02), and virus shedding in seroconverters from other sites was significantly more persistent than in pretransplant antibody positive patients. Thus, CMV infection was due either to reactivation of latent infection or was transmitted along with the renal allograft and manifested as a primary infection.