CMV high-risk status and posttransplant outcomes in kidney transplant recipients treated with belatacept.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Geeta KaradkheleChristian P Larsen

Abstract

Cytomegalovirus (CMV) remains associated with poor outcomes after kidney transplantation (kTx). The impact of belatacept on CMV infection remains understudied. In this study, we assessed the impact of belatacept on patient and graft survivals. CMV seronegative kTx recipients were included. Patient and graft survival were studied using Kaplan-Meier method, log-rank test. Cox models were used to compare outcomes by CMV risk and immunosuppressive regimen. Incidence and persistence of CMV viremia under belatacept vs tacrolimus were compared. Among 308 CMV seronegative recipients, 168 CMV high-risk and 203 belatacept-treated patients were included. High-risk CMV status was associated with lower patient survival and graft survival. Among the CMV high-risk group, patients treated with belatacept presented a higher incidence of CMV viremia, a higher rate of first-line treatment failure and a longer time to virus clearance. They had a nonsignificant trend toward a lower graft survival. Belatacept-based maintenance immunosuppression is associated with an increased risk of CMV primary-infection and a prolonged course of viral replication in CMV high-risk patients. Further studies are needed to confirm the nonsignificant trend towards a lo...Continue Reading

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Citations

Nov 1, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Allan D KirkE Steve Woodle
Feb 15, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Idelberto R BadellChristian P Larsen
Apr 22, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Akansha AgrawalLara Danziger-Isakov
Apr 19, 2021·Enfermedades infecciosas y microbiología clínica·Carlos Santos-AlonsoBelén Loeches-Yagüe
Apr 17, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Jorge Andrade-SierraJuan José Nieves-Hernández
May 9, 2021·BMC Nephrology·Sahra PajendaWolfgang Winnicki
Jul 29, 2021·The New England Journal of Medicine·Olivia C SmibertMatthew B Roberts
Mar 4, 2021·Transplantation·Robin Avery
Jan 28, 2022·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Hanna L KleiboekerJeannina A Smith

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