Latent cytomegalovirus infection is an independent risk factor for late graft failure in renal transplant recipients

Background: Cytomegalovirus(CMV) is a risk factor for rejection and mortality soon after renal transplantation. Little is known about its consequences longer after transplantation. We prospectively investigated whether latent CMV infection is a risk factor for graft failure and mortality long after transplantation.Material/Methods: Our study included 606 renal transplant recipients(RTR) with a functioning graft for >1 year. CMV serology was determined using ELISA. RTRs were divided into CMV-seronegative and latent CMV (seropositive + seroconverted).Results: We measured CMV IgG at 6.0 [2.6-11.4] years post-transplant. During follow-up(7.0 [6.2-7.5] years), 54(9%) RTRs experienced graft failure and 137(23%) RTRs died. Risk for graft failure and mortality was significantly higher in RTRs with latent CMV compared to CMV-seronegative RTRs (HR=3.1, P=0.005 and HR=2.0, P=0.002, respectively). After adjustment for potential confounders, latent CMV infection remained an independent risk factor for graft failure(HR=4.6, P=0.001), but not for mortality(HR=1.4, P=0.2).Conclusions: Latent CMV is an independent risk factor for graft failure long after renal transplantation and carries a higher risk for graft failure than for mortality. These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.