In studies in rats, the interaction between CMV and the alloreactive response in the development of chronic rejection and transplant vascular sclerosis was investigated in small bowel and heart transplantation models [16]

In studies in rats, the interaction between CMV and the alloreactive response in the development of chronic rejection and transplant vascular sclerosis was investigated in small bowel and heart transplantation models [16]. (mmol/L)1.8 [1.3C2.4]1.9 [1.4C2.8]2.0 [1.4C2.6]0.02Use of statin, (%)79 (45)68 (45)153 (55)0.06CRP (mg/L)2.0 [0.7C4.4]2.1 [0.8C4.9]2.0 [1.0C5.5]0.4CMVCMV IgG (U/mL)0 [0C0]110 [62C191]110 [62C198] 0.0001CMV disease, (%)0 (0)66 (43)66 (24) 0.0001CMV curative treatment, n (%)0 (0)49 (32)61 (24) 0.0001 Open in a separate window Values are presented as mean standard deviation, median (interquartile range) or percentages. P for trend was calculated with chi-square, Kruskal-Wallis test and linear regression for dichotomous, ordinal and continuous variables, respectively. Skewed data were normalized by logarithmic transformation in all analyses. *MI C myocardial infarction; **TIA/CVA C transient ischaemic attack/cerebrovascular accident. Table 2 Transplant-related characteristics of renal transplant recipients according to CMV serostatus 1 Cefepime Dihydrochloride Monohydrate year after transplantation. (%)174 (29)152 (25)280 (46)Donor demographicsAge (years)35.915.434.814.938.715.60.02Male, (%)98 (56)82 (54)148 (53)0.8Renal allograft functionSerum creatinine concentration (mol/L)136 [112C162]129 [111C170]134 [114C166]0.8Creatinine clearance (mL/min)66.521.259.621.360.523.50.007Proteinuria (g/24hr)0.2 [0.0C0.4]0.2 [0.0C0.5]0.2 [0.0C0.5]0.7Prior dialysis duration (mo)25 [12C47]26 [15C29]29 [16C53]0.09Transplantation type, (%)Postmortem donor137 (79)134 (88)232 (83)0.06Living donor33 (19)15 (10)35 (12)Combined transplantation4 (2)3 (2)13 (5)Number of previous transplants, (%)0163 (94)134 (88)245 (88)0.011 or more11 (6)18 (12)35 (12)Acute rejection, (%)77 (44)77 (51)118 (42)0.2Immunosuppressive era, (%)from 1968 to January 198930 (17)65 (43)17 (6) 0.0001from January 1989 to February 199319 (11)17 (11)54 (20)from March 1993 to May 199742 (24)32 (21)83 (29)from May 1997 to date83 (48)38 (25)126 (45)ImmunosuppresionPrednisolone dose, (mg/day)10.0 [7.5C10.0]10.0 [7.5C10.0]10.0 [7.5C10.0]0.04Calcineurine inhibitor, (%)140 (81)94 (62)241 (86)P=0.04Cyclosporin, (%)112 (65)81 (53)197 (70)0.5TroughClevel (g/L)114 [82C140]101 [75C128]108 [80C143]0.2Tacrolimus, (%)28 (16)13 (9)44 (16)0.5TroughClevel (g/L)8 [6C11]10 [7C11]9 [6C10]0.7Proliferation inhibitor, (%)Azathioprine or Mycophenolate mofetil133 (76)107 (70)208 (74)0.5 Rabbit Polyclonal to RBM34 Open in a separate window Values are presented as mean standard deviation, median (interquartile range) or percentages. P for trend was calculated with -square, Kruskal Wallis test and linear regression for dichotomous, ordinal and continuous variables, respectively. Skewed data were normalized by logarithmic transformation in all analyses. Results A total of 606 RTRs (55% male, aged 5112 years, 83% post-mortem donor transplants) were analyzed. Median time between transplantation and baseline measurements was 6.0 (2.6C11.4) years. Baseline median anti-CMV IgG was 72.0 (0.0C154.5) U/mL. Baseline characteristics according to CMV serostatus 1 year after transplantation are shown in Tables 1, ?,2;2; 174 (29%) RTRs were CMV-seronegative, 152 (25%) RTRs were CMV-seroconverted and 280 (46%) RTRs were CMV-seropositive. In the CMV-seronegative recipients group, 153 (88%) of the donors were CMV-negative, while 21 (12%) of the donors were CMV-seropositive. In the CMV-seroconverted recipients group, 6 (4%) of the donors were CMV-seronegative, while 146 (96%) were CMV-seropositive. In the CMV-seropositive recipients group, 124 (44%) of the donors were CMV-seronegative, while 154 (55%) were CMV-seropositive. We have no data regarding the CMV serostatus from 2 donors in this group. Recipient CMV serostatus was significantly associated with recipient age, BMI, waist circumference, systolic and diastolic blood pressure, myocardial infarction, triglyceride concentration, donor age, creatinine clearance, immunosuppressive era, dose of prednisolone, and usage of calcineurin inhibitors. CMV disease was connected with CMV serostatus ( em P /em 0 significantly.0001). Altogether, 132 RTRs experienced CMV disease C 66 (43%) from the 152 CMV-seroconverted RTRs and 66 (24%) from the CMV-seropositive RTRs. Inside our medical clinic, the cut-off Cefepime Dihydrochloride Monohydrate level for beginning pre-emptive treatment was when antigenemia examined positive for at least 20 cells/50 000 polymorphonuclear neutrophils, when consecutive raising antigenemia values had been discovered or when symptoms suggestive of CMV an infection had been followed by any antigenemia positivity. Our fairly high cut-off with requirement of symptoms suggestive of CMV an infection for begin of pre-emptive treatment for lower degrees of antigenemia may describe the relatively higher rate of symptomatic attacks. Median follow-up was 7.0 (6.2C7.5) years both for graft failure and. Cefepime Dihydrochloride Monohydrate