Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis
BackgroundCytomegalovirus (CMV) infection poses a significant risk to kidney transplant recipients. CMV immunoglobulin shows promising prophylactic effect, particularly in the context of ABO-incompatible transplants. However, its efficacy in preventing CMV viremia remains underexplored.MethodsIn thi...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Immunology |
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| author | Linhong Zhong Shijie Tang Zhongping Pu Kai Chen Wenjia Di Yifu Hou Hongji Yang Hongji Yang |
| author_facet | Linhong Zhong Shijie Tang Zhongping Pu Kai Chen Wenjia Di Yifu Hou Hongji Yang Hongji Yang |
| author_sort | Linhong Zhong |
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| description | BackgroundCytomegalovirus (CMV) infection poses a significant risk to kidney transplant recipients. CMV immunoglobulin shows promising prophylactic effect, particularly in the context of ABO-incompatible transplants. However, its efficacy in preventing CMV viremia remains underexplored.MethodsIn this retrospective study, we enrolled patients who underwent ABO-incompatible living donor kidney transplantation between May 2021 and September 2023. Prophylactic CMV immunoglobulin was administered at 100 mg/kg weekly for one month in the combined prophylaxis group, while no prophylactic medication was applied in the preemptive therapy group. The primary outcome was measured as the incidence of clinically relevant CMV viremia (CMV DNA >10,000 copies/mL) within one year after transplantation. Both groups received standard preemptive therapy with ganciclovir or valganciclovir after diagnosed with clinically relevant CMV viremia.ResultsProphylactic CMV immunoglobulin significantly reduced clinically relevant viremia incidence compared to preemptive therapy group (16.0% vs. 34.0%, P = 0.04). At the end of the follow-up, the combined prophylaxis group showed higher eGFR (56.40 ± 14.19 vs. 47.30 ± 13.01 mL/min/1.73m², P = 0.0014) and lower serum creatinine (146.5 ± 57.07 vs. 171.2 ± 51.48 µmol/L, P = 0.0274). However, no significant differences in renal function were observed between the groups at1,3, or 6 months post-transplantation.ConclusionCMV immunoglobulin represents a promising prophylactic option for reducing clinically relevant CMV viremia incidence and delaying infection onset in ABO-incompatible kidney transplant recipients. |
| format | Article |
| id | doaj-art-02c24ac89cd0433cb8b5a161aeb0a708 |
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| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-02c24ac89cd0433cb8b5a161aeb0a7082025-08-20T02:29:46ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-04-011610.3389/fimmu.2025.15629511562951Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysisLinhong Zhong0Shijie Tang1Zhongping Pu2Kai Chen3Wenjia Di4Yifu Hou5Hongji Yang6Hongji Yang7Department of Hepatobiliary Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Hepatobiliary Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Hepatobiliary Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Organ Transplantation, Sichuan Provincial Peoples Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Organ Transplantation, Sichuan Provincial Peoples Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Organ Transplantation, Sichuan Provincial Peoples Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Hepatobiliary Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Organ Transplantation, Sichuan Provincial Peoples Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaBackgroundCytomegalovirus (CMV) infection poses a significant risk to kidney transplant recipients. CMV immunoglobulin shows promising prophylactic effect, particularly in the context of ABO-incompatible transplants. However, its efficacy in preventing CMV viremia remains underexplored.MethodsIn this retrospective study, we enrolled patients who underwent ABO-incompatible living donor kidney transplantation between May 2021 and September 2023. Prophylactic CMV immunoglobulin was administered at 100 mg/kg weekly for one month in the combined prophylaxis group, while no prophylactic medication was applied in the preemptive therapy group. The primary outcome was measured as the incidence of clinically relevant CMV viremia (CMV DNA >10,000 copies/mL) within one year after transplantation. Both groups received standard preemptive therapy with ganciclovir or valganciclovir after diagnosed with clinically relevant CMV viremia.ResultsProphylactic CMV immunoglobulin significantly reduced clinically relevant viremia incidence compared to preemptive therapy group (16.0% vs. 34.0%, P = 0.04). At the end of the follow-up, the combined prophylaxis group showed higher eGFR (56.40 ± 14.19 vs. 47.30 ± 13.01 mL/min/1.73m², P = 0.0014) and lower serum creatinine (146.5 ± 57.07 vs. 171.2 ± 51.48 µmol/L, P = 0.0274). However, no significant differences in renal function were observed between the groups at1,3, or 6 months post-transplantation.ConclusionCMV immunoglobulin represents a promising prophylactic option for reducing clinically relevant CMV viremia incidence and delaying infection onset in ABO-incompatible kidney transplant recipients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1562951/fullABO-incompatible kidney transplantationCMV immunoglobulindesensitizationgraft functionimmune deficiency |
| spellingShingle | Linhong Zhong Shijie Tang Zhongping Pu Kai Chen Wenjia Di Yifu Hou Hongji Yang Hongji Yang Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis Frontiers in Immunology ABO-incompatible kidney transplantation CMV immunoglobulin desensitization graft function immune deficiency |
| title | Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis |
| title_full | Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis |
| title_fullStr | Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis |
| title_full_unstemmed | Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis |
| title_short | Impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in ABO-incompatible living donor kidney transplantation: a retrospective analysis |
| title_sort | impact of prophylactic cytomegalovirus immunoglobulin on cytomegalovirus viremia and graft function in abo incompatible living donor kidney transplantation a retrospective analysis |
| topic | ABO-incompatible kidney transplantation CMV immunoglobulin desensitization graft function immune deficiency |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1562951/full |
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