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Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation.
Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time... read more

Published: 2019-07-12

Infectious Complications of Induction Therapies in Kidney Transplantation

Adem Bayraktar, Yunus Catma, Arif Akyildiz, Erol Demir, Huseyin Bakkaloglu, Ali Riza Ucar, Ahmet Burak Dirim, Sebahat Usta Akgul, Sonay Temurhan, Ali Fuat Kaan Gok, Yasemin Ozluk, Isin Kilicaslan, Fatma Savran Oguz, Mehmet Sukru Sever, Ali Emin Aydin, Aydin Turkmen

(Department of General Surgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey)

Ann Transplant 2019; 24:412-417

DOI: 10.12659/AOT.915885

BACKGROUND: Cytomegalovirus (CMV) and BK virus (BKV) are post-transplant opportunistic viral infections that affect patient and graft survival. This study was designed to evaluate the risk of BKV nephropathy and CMV disease in kidney transplant recipients who received induction therapy with ATG or basiliximab.
MATERIAL AND METHODS: We retrospectively analyzed information on 257 adult patients who underwent kidney transplantation between January 2007 and 2017. Patients were categorized into 3 groups according to the induction therapies. The primary endpoint was the onset of CMV disease or biopsy-confirmed BKV nephropathy. The secondary endpoints were biopsy-proven rejection episodes, graft loss, loss to follow-up, and death.
RESULTS: We followed 257 patients for a median of 55.5 months. The incidence of CMV disease was significantly higher in the only ATG group compared to the group without induction treatment (p<0.001). There was no significant difference in the incidence of BKV nephropathy among groups (p>0.05). The dosage of ATG (OR, 10.685; 95% CI, 1.343 5 to 85.009; P=0.025) was independent risk factor for death.
CONCLUSIONS: This study demonstrated that a higher dosage of ATG in high-risk patients is associated with an increased risk of CMV disease and patient death, also, reducing the dosage may be a rational strategy for increasing graft and patient’s survival.

Keywords: BK Virus, Cytomegalovirus, Kidney Transplantation

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