Nephrol Dial Transplant (2000) 15: 711-714
© 2000 European Renal Association-European Dialysis and Transplant Association
The influence of mycophenolate mofetil on the incidence and severity of primary cytomegalovirus infections and disease after renal transplantation
Department of Internal Medicine, Division of Nephrology, University Hospital Nijmegen, The Netherlands
Background. Mycophenolate mofetil (MMF) is increasingly used for immunosuppression after renal transplantation (RTx). The aim of our study was to investigate if the use of MMF has resulted in an increase in the frequency and severity of primary cytomegalovirus (CMV) infections.
Methods. Retrospective study of adult RTx patients who were CMV seronegative and who received a kidney of a CMV seropositive donor in the period 1992–1997 (n=84). Twenty-four of these patients were treated with MMF (in combination with cyclosporin and prednisone; MMF+) and the other 60 were the control group (cyclosporin and prednisone; MMF-). No CMV prophylaxis was given. CMV infection was defined as CMV seroconversion of IgG antibodies. CMV disease was defined as CMV infection and fever in combination with one or more of the following: leukocytopenia, thrombocytopenia, elevated alanine aminotransferase, or histological evidence of tissue invasive disease.
Results. The incidence of primary CMV infections was similar in both groups (MMF+, 75%; MMF-, 63%). CMV disease was more frequent in the MMF+ group than in the MMF- group (67 vs 30%, P<0.05). In the patients with CMV disease, the use of MMF did not affect severity of symptoms, frequency of tissue invasive disease, or frequency or duration of treatment with ganciclovir.
Conclusions. Addition of MMF to the immunosuppressive therapy after RTx did not result in an increase of primary CMV infections.However, these CMV infections led more often to CMV disease in patients treated with MMF than in those without MMF.
Keywords: cytomegalovirus; kidney transplantation; mycophenolate mofetil; primary cytomegalovirus infection
Correspondence and offprint requests to: C. G. ter Meulen, 545 Department of Nephrology, University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B. Canbakan, D. Mizrak, K. Keven, G. Kaygusuz, S. Kutlay, S. Sengul, and B. Erbay Gastric ulcer despite no acid in a renal allograft recipient: what is the link? Nephrol. Dial. Transplant., October 1, 2005; 20(10): 2279 - 2281. [Full Text] [PDF]
|
|
|
|
|
|
S.-A. Sung, G.-J. Ko, J.-Y. Kim, M.-G. Kim, J.-E. Lee, G.-I. Kim, S.-K. Jo, W.-Y. Cho, and H.-K. Kim Desquamative interstitial pneumonia associated with concurrent cytomegalovirus and Aspergillus pneumonia in a renal transplant recipient Nephrol. Dial. Transplant., March 1, 2005; 20(3): 635 - 638. [Full Text] [PDF]
|
|
|
|
 |
|
 R. G. L. D. SEVAUX, P. J. H. S. GREGOOR, R. J. HENE, A. J. HOITSMA, P. VOS, W. WEIMAR, T. V. GELDER, and L. B. HILBRANDS A Controlled Trial Comparing Two Doses of Cyclosporine in Conjunction with Mycophenolate Mofetil and Corticosteroids J. Am. Soc. Nephrol., August 1, 2001; 12(8): 1750 - 1757. [Abstract] [Full Text] [PDF]
|
|