Abstract

Introduction:  Cytomegalovirus (CMV) is a common cause of morbidity and mortality among patients receiving chronic maintenance immunosuppression and is often considered the most important infection in renal transplantation.

Aim of the work Our study evaluated the activation of CMV after renal transplantation in relation to different induction therapy comparing  with no induction therapy.

Materials and methods: a total of 49 patients were enrolled. Eligible patients were assigned to treatment by basiliximab (n = 16) or by ATG (n = 15) or no induction therapy (control group) (n = 18) in addition the main regimen including cyclosporine, MMF and steroid . Patients of ATG group received single bolus ATG induction therapy (8 mg/kg body weight. We did not give any prophylaxis against CMV infection. Endpoint: The primary endpoint of the study was the incidence of PCR proven CMV activation after renal transplantation at the 2nd month. With follow up of any symptomatic CMV activation within first 6th months after transplantation.

Results:  the lowest incidence of CMV episodes was in the non induction group (1/18,5.6%) then  basiliximab group (3/16, 18.8%) then the ATG group (5/15, 33.3%) but statistically insignificant. Also we reported that the incidence of acute rejection episodes is increased in patient with positive CMV disease in all group.

conclusion, we observed a high rate of CMV infection in our recipients within 6 months after transplantation.

Recommendation With induction therapy particularly ATG prophylaxis for CMV is recommended