CYTOMEGALOVIRUS ANTIBODY STATUS AND RENAL-TRANSPLANTATION - 1987-1994

We examined graft and patient survival rates of 47,146 patients in the United Network for Organ Sharing registry following transplants betwe en donors and recipients who were cytomegalovirus (CMV) antibody negat ive and positive, CMV positivity increased with age to about 80% in pa tients over 60, Seropositivity was seen in 80% of Asians, 71% of Afric an Americans, and 56% of Caucasians, In all age groups, females had a slightly higher incidence of positivity than males, Transplants involv ing CMV-positive donors resulted in lower graft survival rates than th ose with CMV-negative donors, This occurred regardless of whether the recipient was CMV negative or positive, The greatest effect was on pat ient survival rate, which, in turn, adversely affected graft survival rate, The CMV-positive-donor effect was primarily noted in (1) Caucasi an recipients, (2) patients with HLA-AB,DR mismatches, and (3) patient s older than 15 years of age, In contrast, CMV-positive donors were no t a risk factor for African American and Hispanic patients, CMV-positi ve Asian patients, patients younger than 16 years of age, and patients with no HLA-AB,DR antigen mismatches, In conclusion, a kidney from a CMV-positive donor is a risk factor for certain patients and currently yields about a 4% overall lower graft survival rate at 3 years than a kidney from a CMV-negative donor.