CYTOMEGALOVIRUS DISEASE OF LATE-ONSET FOLLOWING RENAL-TRANSPLANTATION- A POTENTIALLY FATAL ENTITY

CMV disease (CMVD) is a recognized problem of the early post-transplan t period (PTP) in renal transplant recipients. Information on CMVD in the late (greater than or equal to 2 years) PTP is scarce. We have obs erved 5 cases of CMVD during late (3-8 years) PTP during the last 15 y ears. Three of these patients died from CMVD. One of the patients with late-onset CMVD recovered spontaneously from mild pneumonitis, 1 pati ent with severe CMVD after therapy with ganciclovir/anti-CMV-IgG. CMVD was ascribed to primary infection in 4/5 patients, and transmission w as attributed to blood products in 2 cases. At the time of CMVD, 4/5 p atients were on stable immunosuppression with azathioprine/prednisone; 1 patient who died had received prednisone pulses 1 month prior to CM VD. Late onset CMVD is an underreported disease in renal transplant re cipients, which warrants preventive measures and consideration of anti viral therapy.