ABSENCE OF ASSOCIATION BETWEEN CYTOMEGALOVIRUS-INFECTION AND OBLITERATIVE TRANSPLANT ARTERIOPATHY IN RENAL-ALLOGRAFT REJECTION

Cytomegalovirus (CMV) was recently identified, using in situ hybridiza tion, in the coronary arteries of patients with cardiac transplant rej ection, suggesting a role of CMV in the development of obliterative tr ansplant arteriopathy in cardiac allografts. We sought to verify this observation by examining arteries in kidney transplants with intimal t hickening due to chronic rejection. Eleven renal biopsies and 13 nephr ectomies from 24 patients, all showing obliterative transplant arterio pathy, were collected for this study. Of these patients, six were sero positive for CMV before transplantation, three were identified as sero positive following renal transplantation, nine had no evidence of CMV infection, and clinical data were not available for an additional six patients. Paraffin-embedded renal sections were examined for the prese nce of CMV by immunohistochemistry in situ hybridization and polymeras e chain reaction. By these methods, only one case (1/24) was demonstra ted to have CMV infected cells in the renal interstitium, tubules, and glomeruli, but none (0/24) showed CMV to be located in any of the ren al arteries or arterioles. Thus, our results suggest that obliterative transplant arteriopathy can occur in the absence of demonstrable CMV and is probably unrelated to direct CMV infection of the graft.