Risk Factors for CMV and BK Infections in an Elderly Veteran Population Following Kidney Transplantation: Implications for Immunosuppression Induction and Management

Cytomegalovirus (CMV) and BK Polyomavirus (BKPyV) are the most common opportunistic pathogens following kidney transplantation. We evaluated 102 patients with a median age of 63 at Edward Hines VA Hospital from November 2020 to December 2022. Our primary interest was the incidence of CMV and BKPyV i...

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Bibliographic Details
Published in:Biomedicines 2023-11, Vol.11 (11), p.3060
Main Authors: Thorndyke, Anne, Joyce, Cara, Samra, Manpreet, Cotiguala, Laura, Trotter, Christine, Aguirre, Oswaldo, Chon, W James, Sodhi, Rupinder, Lopez-Soler, Reynold I
Format: Article
Language:English
Subjects:
African Americans
Age
Antilymphocyte serum
Antithymocyte globulin
Biopsy
CMV
co-infection
Cytomegalovirus
Cytomegalovirus infections
Demographics
Diabetes
Drug dosages
Globulins
Graft rejection
Hepatitis
Hypertension
Immunosuppression
Immunotherapy
Infection
Infections
Kidney diseases
kidney transplant
Kidney transplantation
Kidney transplants
Kidneys
Opportunist infection
Patients
Risk factors
Statistical analysis
Thymocytes
Transplantation
Viral infections
Viruses
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Summary:Cytomegalovirus (CMV) and BK Polyomavirus (BKPyV) are the most common opportunistic pathogens following kidney transplantation. We evaluated 102 patients with a median age of 63 at Edward Hines VA Hospital from November 2020 to December 2022. Our primary interest was the incidence of CMV and BKPyV infections, as well as CMV and BKPyV coinfection. Secondary interests included time to infection, rejection, and graft and patient survival. There were no statistically significant differences in patient age, donor age, race, transplant type, incidence of delayed graft function, or induction in both cohorts (any infection (N = 46) vs. those without (N = 56)). There was a 36% (37/102) incidence of CMV, a 17.6% (18/102) of BKPyV and an 8.8% (9/102) incidence of coinfection. There was a decreased incidence of CMV infection in Basiliximab induction versus antithymocyte globulin (21% and 43%). CMV risk status had no effect on the incidence of CMV infection following transplant. African American recipients had a lower incidence of BKPyV infection (12% vs. 39%), yet a higher incidence was observed in those with high cPRA (50% vs. 14%). Most CMV and/or BKPyV infections occurred within the first six months post-transplant (54%). Immunosuppression management of the elderly should continually be evaluated to reduce opportunistic infections post-transplant.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines11113060