Renal Doppler sonographic and histologic findings in post-transplant primary cytomegalovirus disease

Cytomegalovirus (CMV) infections frequently develop in renal transplant pat ients. The transplanted kidney may be not only the source of infection but also the Target for it. We report a case of primary CMV infection in a sero negative patient who received a graft from a seropositive cadaveric donor. The onset of CMV was clinically apparent on posttransplant day 22. Interest ingly, soon after transplantation, the patient developed a long-lasting gra ft dysfunction episode for which diffuse endothelial-cell swelling was the most relevant finding at biopsy. On sonography, renal graft vascular impeda nce deteriorated and improved repeatedly during the follow-up period. We po stulate that the patient had CMV-induced immunogenic-mediated endothelial-c ell injury. (C) 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:430-434, 2000.