LATE-ACUTE VENAL ALLOGRAFT-REJECTION AND SYMPTOMLESS CYTOMEGALOVIRUS-INFECTION

The role of cytomegalovirus infection in allograft injury is controver sial. A subgroup of renal graft recipients who bad histologically prov en late-acute rejection did not respond to conventional anti-rejection therapy (80% graft loss within 1 year). These patients showed an expa nsion of memory-type CD8 peripheral-blood T cells that expressed inter feron-gamma mRNA and an association with clinically symptomless cytome galovirus infection (82% PCR positive, 42% antigenaemia). Antiviral th erapy with ganciclovir resulted in stable improved graft function in 1 7 of 21 treated patients with cytomegalovirus-associated late-acute re jection. The results underline the clinical relevance of cytomegalovir us-related graft injury and offer a novel therapeutic approach.