Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients
Background. Kidney transplant recipients (KTRs) experience a high burden of cytomegalovirus infection (CMV R+) and long-term premature cognitive aging. We tested whether CMV was associated with post-KT cognitive impairment. Methods. In a 2-center prospective cohort study of 574 KTRs (mean age: 54.7...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-09-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001818 |
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| author | Maheen Z. Abidi, MD Xiaomeng Chen, MSPH Yi Liu, ScM Nadia M. Chu, PhD Aarti Mathur, MD, PhD Adriana Weinberg, MD Bruce Kaplan, MD Silas Norman, MD Jingyao Hong, MHS Dorry L. Segev, MD, PhD Kristine M. Erlandson, MD Mara A. McAdams-DeMarco, PhD |
| author_facet | Maheen Z. Abidi, MD Xiaomeng Chen, MSPH Yi Liu, ScM Nadia M. Chu, PhD Aarti Mathur, MD, PhD Adriana Weinberg, MD Bruce Kaplan, MD Silas Norman, MD Jingyao Hong, MHS Dorry L. Segev, MD, PhD Kristine M. Erlandson, MD Mara A. McAdams-DeMarco, PhD |
| author_sort | Maheen Z. Abidi, MD |
| collection | DOAJ |
| description | Background. Kidney transplant recipients (KTRs) experience a high burden of cytomegalovirus infection (CMV R+) and long-term premature cognitive aging. We tested whether CMV was associated with post-KT cognitive impairment.
Methods. In a 2-center prospective cohort study of 574 KTRs (mean age: 54.7 y), we obtained CMV donor/recipient (D/R) serostatus and measured pre- and post-KT cognitive function using the Modified Mini-Mental State Examination. We estimated post-KT global cognitive function trajectories by CMV serostatus using adjusted mixed effect models with linear spline terms.
Results. Two hundred twenty-two (38.6%) recipients were CMV D+/R+, 100 (17.4%) were CMV D+/R–, 153 (26.6%) were CMV D–/R+, and 99 (17.2%) were CMV D–/R–. At the time of KT, there were no significant differences in global cognitive function scores among KTRs irrespective of CMV D/R status. Cognitive function equally improved in all CMV D/R groups during the first 3 y post-KT (slope = 0.62 points/year; 95% confidence interval [CI], 0.17-1.07). However, during years 3–8 post-KT, the global cognitive function score trajectories significantly declined in the CMV D+/R+ KTRs (slope = –3.51 points/year; 95% CI, –5.07 to –1.95) but not in the other groups, including CMV D–/R– (slope = 0.44 points/year; 95% CI, –2.12 to 3.00; P = 0.01), CMV D–/R+ (slope = 0.13 points/year; 95% CI, –1.83 to 2.09), or CMV D+/R– (slope = 0.01 points/year; 95% CI, –1.87 to 1.89).
Conclusions. CMV D+/R+ KTRs may be at elevated risk for post-KT cognitive impairment; clinicians may prioritize early interventions in this population. |
| format | Article |
| id | doaj-art-117ffb0feac14cc2b4672a5072a2b58d |
| institution | Kabale University |
| issn | 2373-8731 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Wolters Kluwer |
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| series | Transplantation Direct |
| spelling | doaj-art-117ffb0feac14cc2b4672a5072a2b58d2025-08-26T03:26:16ZengWolters KluwerTransplantation Direct2373-87312025-09-01119e181810.1097/TXD.0000000000001818202509000-00003Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant RecipientsMaheen Z. Abidi, MD0Xiaomeng Chen, MSPH1Yi Liu, ScM2Nadia M. Chu, PhD3Aarti Mathur, MD, PhD4Adriana Weinberg, MD5Bruce Kaplan, MD6Silas Norman, MD7Jingyao Hong, MHS8Dorry L. Segev, MD, PhD9Kristine M. Erlandson, MD10Mara A. McAdams-DeMarco, PhD111 Division of Infectious Diseases, Department of Medicine, University of Colorado, Denver, CO.2 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.2 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.2 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.2 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.3 Division of Pediatric Infectious Diseases, Department of Medicine, University of Colorado, Denver, CO.4 Department of Surgery, University of Colorado, Denver, CO.5 Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.6 Department of Surgery, NYU Grossman School of Medicine and Langone Health, New York, NY.6 Department of Surgery, NYU Grossman School of Medicine and Langone Health, New York, NY.1 Division of Infectious Diseases, Department of Medicine, University of Colorado, Denver, CO.6 Department of Surgery, NYU Grossman School of Medicine and Langone Health, New York, NY.Background. Kidney transplant recipients (KTRs) experience a high burden of cytomegalovirus infection (CMV R+) and long-term premature cognitive aging. We tested whether CMV was associated with post-KT cognitive impairment. Methods. In a 2-center prospective cohort study of 574 KTRs (mean age: 54.7 y), we obtained CMV donor/recipient (D/R) serostatus and measured pre- and post-KT cognitive function using the Modified Mini-Mental State Examination. We estimated post-KT global cognitive function trajectories by CMV serostatus using adjusted mixed effect models with linear spline terms. Results. Two hundred twenty-two (38.6%) recipients were CMV D+/R+, 100 (17.4%) were CMV D+/R–, 153 (26.6%) were CMV D–/R+, and 99 (17.2%) were CMV D–/R–. At the time of KT, there were no significant differences in global cognitive function scores among KTRs irrespective of CMV D/R status. Cognitive function equally improved in all CMV D/R groups during the first 3 y post-KT (slope = 0.62 points/year; 95% confidence interval [CI], 0.17-1.07). However, during years 3–8 post-KT, the global cognitive function score trajectories significantly declined in the CMV D+/R+ KTRs (slope = –3.51 points/year; 95% CI, –5.07 to –1.95) but not in the other groups, including CMV D–/R– (slope = 0.44 points/year; 95% CI, –2.12 to 3.00; P = 0.01), CMV D–/R+ (slope = 0.13 points/year; 95% CI, –1.83 to 2.09), or CMV D+/R– (slope = 0.01 points/year; 95% CI, –1.87 to 1.89). Conclusions. CMV D+/R+ KTRs may be at elevated risk for post-KT cognitive impairment; clinicians may prioritize early interventions in this population.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001818 |
| spellingShingle | Maheen Z. Abidi, MD Xiaomeng Chen, MSPH Yi Liu, ScM Nadia M. Chu, PhD Aarti Mathur, MD, PhD Adriana Weinberg, MD Bruce Kaplan, MD Silas Norman, MD Jingyao Hong, MHS Dorry L. Segev, MD, PhD Kristine M. Erlandson, MD Mara A. McAdams-DeMarco, PhD Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients Transplantation Direct |
| title | Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients |
| title_full | Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients |
| title_fullStr | Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients |
| title_full_unstemmed | Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients |
| title_short | Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients |
| title_sort | cognitive impairment in cmv seropositive and cmv seronegative deceased donor kidney transplant recipients |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001818 |
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