Bimonthly Viral Monitoring for Late-onset Cytomegalovirus Infection in Kidney Transplant Recipients

July 5, 2021

In a paper published in Clinical Transplantation, researchers from the Renal-Electrolyte Division and Thomas E. Starzl Transplantation Institute found that bimonthly monitoring for late-onset cytomegalovirus (CMV) allows for early CMV detection and could lower CMV-related hospitalization in kidney transplant recipients. 

Kidney transplant recipients with high-risk CMV serostatus — seropositive donor to seronegative recipient — are at risk for late-onset CMV after ending antiviral prophylaxis. Researchers report findings from a strategy of bimonthly CMV screening for late-onset CMV through a single-center retrospective cohort study of 70 high-risk CMV kidney transplant recipients. 

Patients were monitored at 6–12 months post-transplantation for late-onset CMV using bimonthly CMV nucleic acid testing (NAT). Adherence to screening and correlation to CMV-related hospitalizations were assessed.

Twenty-one patients (30%) developed CMV DNAemia with 10 (14%) requiring hospitalization. Reasons for CMV-related hospitalization despite screening protocols were screening non-adherence (50%), rapid progression (40%), and health system failure (10%). 

Adherence to screening was also associated with lower viral counts at diagnosis and a trend toward lower risk of CMV-related hospitalization.

Reference 

Melgarejo I, Jorgensen D, Hariharan S, Puttarajappa CM. Bimonthly viral monitoring for late-onset cytomegalovirus infection in kidney transplant recipients. Clin Transplant. 2021 May;35(5):e14259. doi: 10.1111/ctr.14259. Epub 2021 Mar 5. PMID: 33605490.