FACTORS INFLUENCING THE OCCURRENCE OF ACTIVE CYTOMEGALOVIRUS (CMV) INFECTIONS AFTER ORGAN-TRANSPLANTATION

In this study, several factors influencing the occurrence of active CM V infection after organ transplantation (Tx) are analysed. For this pu rpose, 105 heart, kidney and lung transplant recipients who were CMV-p ositive or had a CMV-positive donor, were closely monitored for active CMV infection by antigenaemia, cultures, CMV serology and lymphocyte proliferation (LP) to CMV. Univariate and multivariate regression anal ysis were performed. As pretransplant risk factors the HLA-type and nu mbers of HLA mismatches between recipients and their donors, and the C MV serology of the recipient and donor were analysed. A new finding wa s that recipients of donors positive for HLA-B7 were especially at ris k for developing active CMV infection (P=0.03) and CMV disease (P=0.03 ). This was not due to increased rejection treatment in these patients . Post-transplant risk factors for development of active CMV infection were absence of detectable cellular immunity to CMV (lymphocyte proli feration) after Tx (P<0.01) and rejection treatment with OKT3 or ATG ( P=0.05). High levels of IgG anti-CMV did not prevent occurrence of act ive CMV infection or CMV disease in the CMV+ recipients.